Provider Demographics
NPI:1912113978
Name:SONOSCAN GENETIC SCIENCES
Entity Type:Organization
Organization Name:SONOSCAN GENETIC SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDEIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-544-1500
Mailing Address - Street 1:11203 QUEENS BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5550
Mailing Address - Country:US
Mailing Address - Phone:718-544-1500
Mailing Address - Fax:718-460-1322
Practice Address - Street 1:11203 QUEENS BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5550
Practice Address - Country:US
Practice Address - Phone:718-544-1500
Practice Address - Fax:718-460-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01226AMedicare PIN