| Organization Name: | EAST QUEENS MEDICAL DIAGNOSTIC SERVICES, PC |
| NPI Number: | 1003097270 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLINTON J SEWELL (PRESIDENT) |
| Mailing Address: | 23011 Linden Blvd Cambria Heights |
| State: | NY US |
| Postal Code: | 114111851 |
| Phone Number: | 7182763400 |
| Fax Number: | 7182763402 |
| NPI Enumeration Date: | 11/16/2007 |
| NPI Last Update Date: | 11/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 116260 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |