Modern Image of Ny

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MODERN IMAGE OF NY

Practice address

2965 Ocean Pkwy
507
Brooklyn, NY 11235-8014

Phone

(718) 996-9088

Fax

(718) 535-7876

NPI assigned

Apr 16, 2007

Last updated

Sep 18, 2009By 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

Raisa Evans

Title

Pres.

Phone

(718) 996-9088

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1851516736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 OCEAN PKWY",
            "address_2": "507",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358014",
            "telephone_number": "718-996-9088",
            "fax_number": "718-535-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 OCEAN PKWY",
            "address_2": "507",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358014",
            "telephone_number": "718-996-9088",
            "fax_number": "718-535-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN IMAGE OF NY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "RAISA",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "718-996-9088"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01832017",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Modern Dentistry Vas of Brooklyn, PLLC
• Modern Diagnostic Laboratory, Inc
• Modern Eyes Optical 8 Inc
• Modern Eyes Optical LLC
• Modern Gastroenterology PC
• Modern Medical Care of Ny PLLC
• Modern Medical Care of Ny PLLC
• Modern Medical Care PC
• Modern Medical PLLC
• Modern Medical Supply Inc

• Durable Medical Equipment & Medical Supplies in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.