Healthcare Provider Details

I. General information

NPI: 1861806663
Provider Name (Legal Business Name): NEW YORK DIAGNOSTIC SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W PALMETTO PARK ROAD SUITE 205
BOCA RATON FL
33433
US

IV. Provider business mailing address

7000 W PALMETTO PARK ROAD SUITE 205
BOCA RATON FL
33433
US

V. Phone/Fax

Practice location:
  • Phone: 855-200-8262
  • Fax: 561-584-5849
Mailing address:
  • Phone: 855-200-8262
  • Fax: 561-584-5849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number170764-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number196728-1
License Number StateNY

VIII. Authorized Official

Name: BRADLEY ARTEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 855-200-8262