Healthcare Provider Details

I. General information

NPI: 1952447690
Provider Name (Legal Business Name): BRONXBRIDGE NUCLEAR MEDICAL IMAGING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 WILLIAMSBRIDGE RD STE LL
BRONX NY
10461
US

IV. Provider business mailing address

1610 WILLIAMSBRIDGE RD STE LL
BRONX NY
10461
US

V. Phone/Fax

Practice location:
  • Phone: 718-409-4960
  • Fax: 718-409-4961
Mailing address:
  • Phone: 718-409-4960
  • Fax: 718-409-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. THOMAS DALESSANDRO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 718-409-4960