Provider Demographics
NPI:1922012368
Name:RADIOLOGY IMAGING ASSOCATES OF BROOKLYN, PC
Entity Type:Organization
Organization Name:RADIOLOGY IMAGING ASSOCATES OF BROOKLYN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-283-6157
Mailing Address - Street 1:4912 HIGBEE AVE NW
Mailing Address - Street 2:SUITE #100
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2530
Mailing Address - Country:US
Mailing Address - Phone:877-688-6122
Mailing Address - Fax:800-310-0634
Practice Address - Street 1:6300 8TH AVE
Practice Address - Street 2:PET SUITE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4718
Practice Address - Country:US
Practice Address - Phone:718-765-2718
Practice Address - Fax:718-283-7735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWTF261Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER #