Provider Demographics
NPI:1942244678
Name:MOTRONI, BETTY T (MD)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:T
Last Name:MOTRONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:
Other - Last Name:TRIANTAFILLOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2800 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1113
Mailing Address - Country:US
Mailing Address - Phone:516-622-6000
Mailing Address - Fax:516-622-2914
Practice Address - Street 1:150 E SUNRISE HWY
Practice Address - Street 2:SUITE 208
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2598
Practice Address - Country:US
Practice Address - Phone:631-225-7200
Practice Address - Fax:631-930-9451
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2013162085B0100X, 2085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01909599Medicaid
NY01909599Medicaid
NY300118652Medicare PIN
NY609591Medicare PIN
NYBM06095910Medicare PIN