Provider Demographics
NPI:1063740231
Name:NEW MILLENNIUM RADIOLOGY, PC
Entity type:Organization
Organization Name:NEW MILLENNIUM RADIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:LISANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-321-7100
Mailing Address - Street 1:13848 ELDER AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4066
Mailing Address - Country:US
Mailing Address - Phone:718-321-7100
Mailing Address - Fax:718-321-7115
Practice Address - Street 1:13848 ELDER AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4066
Practice Address - Country:US
Practice Address - Phone:718-321-7100
Practice Address - Fax:718-321-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty