Healthcare Provider Details

I. General information

NPI: 1689785644
Provider Name (Legal Business Name): LONG ISLAND RADIOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 FRANKLIN AVE
HEWLETT NY
11557-1902
US

IV. Provider business mailing address

545 ELMONT RD
ELMONT NY
11003-4002
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-5500
  • Fax: 516-569-8225
Mailing address:
  • Phone: 516-354-4200
  • Fax: 516-977-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DENNIS R. ROSSI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 516-354-4200