Provider Demographics
NPI:1336220292
Name:MEDSONIC, INC.
Entity Type:Organization
Organization Name:MEDSONIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-648-0808
Mailing Address - Street 1:3060 OCEAN AVE
Mailing Address - Street 2:SUITE LP
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3364
Mailing Address - Country:US
Mailing Address - Phone:718-648-0808
Mailing Address - Fax:
Practice Address - Street 1:3060 OCEAN AVE
Practice Address - Street 2:SUITE LP
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3364
Practice Address - Country:US
Practice Address - Phone:718-648-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY358602471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z081Medicare ID - Type UnspecifiedIDTF