Provider Demographics
NPI:1972553865
Name:METROPOLITAN SOUND IMAGING INC.
Entity Type:Organization
Organization Name:METROPOLITAN SOUND IMAGING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:KIRCHER
Authorized Official - Suffix:SR
Authorized Official - Credentials:RT(R)
Authorized Official - Phone:631-406-4210
Mailing Address - Street 1:544 JEFFERSON PLZ
Mailing Address - Street 2:#22
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-5001
Mailing Address - Country:US
Mailing Address - Phone:631-406-4210
Mailing Address - Fax:631-406-4202
Practice Address - Street 1:66 CLIFF RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1033
Practice Address - Country:US
Practice Address - Phone:631-406-4210
Practice Address - Fax:631-406-4202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY51023476261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02333842Medicaid
NY02935037Medicaid
NYJ300047733Medicare PIN
NY02333842Medicaid
NY02935037Medicaid