Provider Demographics
NPI:1700331196
Name:JOSEPH B. FURLONG, P.A.
Entity Type:Organization
Organization Name:JOSEPH B. FURLONG, P.A.
Other - Org Name:PHYSICIANS IMAGING & VEIN CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:FURLONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-771-8346
Mailing Address - Street 1:190 HOWARD PLACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011
Mailing Address - Country:US
Mailing Address - Phone:575-288-3216
Mailing Address - Fax:575-288-3218
Practice Address - Street 1:190 HOWARD PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:575-288-3216
Practice Address - Fax:575-288-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty