Main Street Medical Imaging, PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MAIN STREET MEDICAL IMAGING, PC

Practice address

239 E Main St Ste a
Patchogue, NY 11772-3105

Phone

(631) 447-2700

Fax

(631) 447-3636

NPI assigned

May 18, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Brijkumar Yamraj

Title

Billing Collection Manager

Phone

(917) 935-6575

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689101875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 E MAIN ST STE A",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723105",
            "telephone_number": "631-447-2700",
            "fax_number": "631-447-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 E MAIN ST STE A",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723105",
            "telephone_number": "631-447-2700",
            "fax_number": "631-447-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET MEDICAL IMAGING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "YAMRAJ",
        "authorized_official_first_name": "BRIJKUMAR",
        "authorized_official_title_or_position": "BILLING COLLECTION MANAGER",
        "authorized_official_telephone_number": "917-935-6575",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daragh Elizabeth Maggio, OTR/L
• Felisa Mahabal
• Elnaz Mahbub, DO
• Jennifer Mahon, REGISTERED NURSE
• Main St. Med Care PC
• Main Street Primary Medicine
• Jayeshkumar Makavana, MD
• Nita Krishna Malik, N.P.
• Gary D Mancuso, RPH
• Gloria Kay Mancuso, OG NP

• Diagnostic Radiology Physician in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.