Provider Demographics
NPI:1124074539
Name:ALPHA MAGNETIC RESONANCE IMAGING, PC
Entity type:Organization
Organization Name:ALPHA MAGNETIC RESONANCE IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-829-1500
Mailing Address - Street 1:199 LEE AVE
Mailing Address - Street 2:SUITE 657
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-8036
Mailing Address - Country:US
Mailing Address - Phone:718-829-1500
Mailing Address - Fax:718-504-5339
Practice Address - Street 1:1201 MORRIS PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1905
Practice Address - Country:US
Practice Address - Phone:718-829-1500
Practice Address - Fax:718-504-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEZ341Medicare ID - Type Unspecified