Provider Demographics
NPI:1750338828
Name:CLEAR IMAGE ULTRASOUND CORP.
Entity type:Organization
Organization Name:CLEAR IMAGE ULTRASOUND CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUPENKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-339-9400
Mailing Address - Street 1:1839 E 13TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2807
Mailing Address - Country:US
Mailing Address - Phone:718-339-9400
Mailing Address - Fax:718-758-4203
Practice Address - Street 1:1839 E 13TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2807
Practice Address - Country:US
Practice Address - Phone:718-339-9400
Practice Address - Fax:718-758-4203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center