Avalon Radiology, P.C.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

177726-5 Issued in NY

Legal business name

AVALON RADIOLOGY, P.C.

Practice address

2085 West 11TH Street
Brooklyn, NY 11223

Phone

(718) 787-9192

Fax

(347) 702-7700

NPI assigned

May 29, 2014

Last updated

May 29, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles Demarco, M.D.

Title

Owner

Phone

(718) 787-9192

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1639581358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 WEST 11TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11223",
            "telephone_number": "718-787-9192",
            "fax_number": "347-702-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 WEST 11TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11223",
            "telephone_number": "718-787-9192",
            "fax_number": "347-702-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON RADIOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-787-9192",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "177726-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.