Provider Demographics
NPI:1124990858
Name:SERGE SOMROV RADIOLOGY PLLC
Entity type:Organization
Organization Name:SERGE SOMROV RADIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMROV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-584-6573
Mailing Address - Street 1:127 MATHIAS WEIDEN DR
Mailing Address - Street 2:
Mailing Address - City:NARROWSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12764-6324
Mailing Address - Country:US
Mailing Address - Phone:718-618-7572
Mailing Address - Fax:718-236-4696
Practice Address - Street 1:7714 BAY PKWY APT 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1535
Practice Address - Country:US
Practice Address - Phone:718-618-7572
Practice Address - Fax:718-236-4696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty