Healthcare Provider Details

I. General information

NPI: 1649578923
Provider Name (Legal Business Name): PARK RADIOLOGY,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7336 GRAND AVE
MASPETH NY
11378-1531
US

IV. Provider business mailing address

7336 GRAND AVE
MASPETH NY
11378-1531
US

V. Phone/Fax

Practice location:
  • Phone: 718-507-8184
  • Fax: 718-507-8185
Mailing address:
  • Phone: 718-507-8184
  • Fax: 718-507-8185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number205501
License Number StateNY

VIII. Authorized Official

Name: DR. STEVEN PAUL BROWNSTEIN
Title or Position: MEDICAL DIRECTOR/ OWNER
Credential: M.D.
Phone: 908-687-2552