Provider Demographics
NPI:1902000755
Name:NUCLEAR CARDIAC AND MEDICAL IMAGING SERVICES, PC
Entity Type:Organization
Organization Name:NUCLEAR CARDIAC AND MEDICAL IMAGING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARKARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-231-0300
Mailing Address - Street 1:PO BOX 13126
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-0561
Mailing Address - Country:US
Mailing Address - Phone:631-231-0300
Mailing Address - Fax:631-231-3331
Practice Address - Street 1:150 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8529
Practice Address - Country:US
Practice Address - Phone:212-644-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08133OtherGHI MEDICARE
NYWZZZT1Medicare PIN
NY08133Medicare PIN