Provider Demographics
NPI:1962542381
Name:DYNAMIC MEDICAL IMAGING, PC
Entity type:Organization
Organization Name:DYNAMIC MEDICAL IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BROWNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-507-8184
Mailing Address - Street 1:8 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3024
Mailing Address - Country:US
Mailing Address - Phone:908-687-2552
Mailing Address - Fax:908-687-6556
Practice Address - Street 1:7336 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1531
Practice Address - Country:US
Practice Address - Phone:718-507-8184
Practice Address - Fax:718-507-8185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02276915Medicaid
NY4194976OtherGHI
NY=========BR01OtherCAREPLUS
NY02276915Medicaid
NY=========01OtherMETROPLUS
NY02276915Medicaid