Healthcare Provider Details

I. General information

NPI: 1598259996
Provider Name (Legal Business Name): DS MEDICAL DIAGNOSTICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13249 41ST RD STE 1C
FLUSHING NY
11355-4286
US

IV. Provider business mailing address

13620 38TH AVE # 3A-2B
FLUSHING NY
11354-4277
US

V. Phone/Fax

Practice location:
  • Phone: 877-372-3266
  • Fax: 877-372-3266
Mailing address:
  • Phone: 877-372-3266
  • Fax: 877-372-3266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT SPRINGER
Title or Position: DIRECTOR
Credential: MD
Phone: 773-723-2668