MAIN STREET MEDICAL IMAGING, PC (NPI# 1689101875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689101875 |
| Entity Type | Organization |
| Organization Name | MAIN STREET MEDICAL IMAGING, PC |
| Practice Address |
239 E Main St Ste A Patchogue NY 11772-3105 |
| Practice Telephone | (631) 447-2700 |
| Practice Fax Number | 6314473636 |
| Mailing Telephone | 6314472700 |
| Mailing Fax Number | 6314473636 |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2017-05-18 |
| Authorized Official Name | MR. BRIJKUMAR YAMRAJ (BILLING COLLECTION MANAGER) |
| Authorized Official Telephone | 9179356575 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
239 E MAIN ST STE A |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114900925 | Bonnie Rosen | Radiology | 77 Medford Ave, Patchogue, NY 11772-1281 | 2005-11-25 |
| 1326021163 | David Weltman | Radiology | 101 Hospital Rd., Patchogue, NY 11772-0000 | 2005-11-25 |
| 1740758382 | Brianna Salvia | Radiology | 122 W Roe Blvd, Patchogue, NY 11772-2569 | 2018-11-12 |
| 1831459684 | Parkway Imaging & Diagnostic PC | Radiology | 450 Waverly Ave, Patchogue, NY 11772-1555 | 2012-05-25 |
| 1528341203 | Eric Fabian Greif | Radiology | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2011-09-20 |
| 1356413785 | Victor Mandanas | Radiology | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2006-11-14 |
| 1952314650 | Frank Peter Lombardo | Radiology | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2006-08-14 |
| 1285659649 | Hamid M Alam | Radiology | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2006-07-13 |
| 1417928060 | Arlene Sussman | Radiology | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2006-01-31 |
| 1770566580 | Stephen Robinson | Radiology | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2005-11-25 |
| Find all providers in PATCHOGUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.