Basic Information
| Provider Information | |||||||||
| NPI: | 1619124963 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIGHWAY IMAGING ASSOCIATES, LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 18005 | ||||||||
| Address2: | |||||||||
| City: | HAUPPAUGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117888805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6315178006 | ||||||||
| FaxNumber: | 6315178007 | ||||||||
| Practice Location | |||||||||
| Address1: | 1414 NEWKIRK AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112266522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183386868 | ||||||||
| FaxNumber: | 7182523650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2008 | ||||||||
| LastUpdateDate: | 08/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | BERLLY | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR/RADIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 7183386868 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.