Provider Demographics
NPI:1780937094
Name:FIVE TOWNS IMAGING MEDICAL PC
Entity type:Organization
Organization Name:FIVE TOWNS IMAGING MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-804-8590
Mailing Address - Street 1:755 BRONX RIVER RD
Mailing Address - Street 2:APT 4H
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6962
Mailing Address - Country:US
Mailing Address - Phone:914-382-6801
Mailing Address - Fax:
Practice Address - Street 1:650 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2301
Practice Address - Country:US
Practice Address - Phone:516-804-8590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337149261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty