Basic Information
| Provider Information | |||||||||
| NPI: | 1942244678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOTRONI | ||||||||
| FirstName: | BETTY | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | TRIANTAFILLOU | ||||||||
| OtherFirstName: | BETTY | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2800 MARCUS AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110421113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166226000 | ||||||||
| FaxNumber: | 5166222914 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 E SUNRISE HWY | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | LINDENHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117572598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312257200 | ||||||||
| FaxNumber: | 6319309451 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 12/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 201316 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085U0001X | 201316 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | 2085R0202X | 201316 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 01909599 | 05 | NY | MEDICAID |