Provider Demographics
NPI:1912256728
Name:BRIGHTON RADIOLOGY
Entity type:Organization
Organization Name:BRIGHTON RADIOLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-728-6284
Mailing Address - Street 1:3572 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-3101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3572 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3101
Practice Address - Country:US
Practice Address - Phone:724-728-6284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANONE243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA131761OtherMEDICARE