Provider Demographics
NPI:1104125400
Name:SONOELITE IMAGING, INC.
Entity type:Organization
Organization Name:SONOELITE IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLEJO
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS
Authorized Official - Phone:347-617-1697
Mailing Address - Street 1:8435 101ST ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1110
Mailing Address - Country:US
Mailing Address - Phone:718-355-9096
Mailing Address - Fax:718-725-7103
Practice Address - Street 1:8435 101ST ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1110
Practice Address - Country:US
Practice Address - Phone:718-355-9096
Practice Address - Fax:718-725-7103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132113246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty