MEDICARE: ARDSLEY RADIOLOGY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	1189841	NY

General Provider Information

NPI Number	:	1053593434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARDSLEY RADIOLOGY PC

Provider Business Mailing Address
First Line	:	933 SAW MILL RIVER RD
Second Line	:
City	:	ARDSLEY
State	:	NY
Zip	:	10502-1106
Country	:	US
Telephone Number	:	914-693-4900
Fax Number	:	914-674-0772

Provider Business Practice Location Address
First Line	:	933 SAW MILL RIVER RD
Second Line	:
City	:	ARDSLEY
State	:	NY
Zip	:	10502-1106
Country	:	US
Telephone Number	:	914-693-4900
Fax Number	:	914-674-0772

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	JOSEPH ROWAN
Credential	:
Telephone Number	:	914-693-4900

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	11/28/2007

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