Organization Name: | NORTHERN BOULEVARD IMAGING, MDPC |
NPI Number: | 1013994078 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALLEN ROTHPEARL (SENIOR PARTNER) |
Mailing Address: | 16425 Northern Blvd Flushing |
State: | NY US |
Postal Code: | 113582646 |
Phone Number: | 7183584075 |
Fax Number: | 7183584076 |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 09/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |