Organization
AIM 4 LIFE MEDICAL DIAGNOSTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NODARI MIKHELASHVILI MD (DOCTOR)
(718) 279-0020
Entity
Organization
Contact information
Practice address
6829 SPRINGFIELD BLVD, BAYSIDE, NY 11365
(718) 279-0020
Mailing address
3820 208TH ST, BAYSIDE, NY 11361-1929
(718) 279-0020
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
11/15/2007
Last updated
11/15/2007
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