Provider Demographics
NPI:1780371740
Name:MEDICAL ULTRASOUND READING PC
Entity type:Organization
Organization Name:MEDICAL ULTRASOUND READING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLSENIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-615-4100
Mailing Address - Street 1:2560 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4507
Mailing Address - Country:US
Mailing Address - Phone:718-615-4100
Mailing Address - Fax:
Practice Address - Street 1:2560 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4507
Practice Address - Country:US
Practice Address - Phone:718-615-4100
Practice Address - Fax:718-615-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty