Provider Demographics
NPI:1053564781
Name:NEW YORK PET IMAGING CENTER LLC
Entity type:Organization
Organization Name:NEW YORK PET IMAGING CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRANJAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MITTAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-439-5111
Mailing Address - Street 1:7404 5TH AVE STE LL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2704
Mailing Address - Country:US
Mailing Address - Phone:718-439-5111
Mailing Address - Fax:866-790-3506
Practice Address - Street 1:7404 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2704
Practice Address - Country:US
Practice Address - Phone:718-439-5111
Practice Address - Fax:866-790-3506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NIRANJAN K. MITTAL, PHYSICIAN, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-28
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYH98121487078261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1083680003OtherNPI FOR NIRANJAN K MITTAL
NY1053564781OtherNPI
NYA300001707OtherPTAN
NY1639143324OtherNPI FOR KAROLYN KERR