Organization Name: | WESTERN NASSAU DIAGNOSTIC IMAGING SERVICES P.C. |
NPI Number: | 1033145289 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALLEN ROTHPEARL (PRESIDENT) |
Mailing Address: | 2420 Keeler Ave Merrick |
State: | NY US |
Postal Code: | 115664222 |
Phone Number: | 5165469200 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 07/08/2007 |
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: |