Provider Demographics
NPI:1942259627
Name:UIMA - VIR MEDICINE, PLLC
Entity Type:Organization
Organization Name:UIMA - VIR MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRIGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENBLIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-493-7816
Mailing Address - Street 1:WESTCHESTER MEDICAL CENTER
Mailing Address - Street 2:95 GRASSLANDS RD, MACY PAV, RM 1319
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-7816
Mailing Address - Fax:914-493-7561
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:WESTCHESTER MEDICAL CENTER
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1646
Practice Address - Country:US
Practice Address - Phone:914-493-7816
Practice Address - Fax:914-493-7561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY IMAGING AND MEDICAL ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWHW271Medicare PIN