Healthcare Provider Details

I. General information

NPI: 1871839886
Provider Name (Legal Business Name): MSK ULTRASOUND AND IMAGING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 GREENWICH ST APT 843
NEW YORK NY
10014-6345
US

IV. Provider business mailing address

666 GREENWICH ST APT 843
NEW YORK NY
10014-6345
US

V. Phone/Fax

Practice location:
  • Phone: 646-509-7410
  • Fax: 718-748-2266
Mailing address:
  • Phone: 646-509-7410
  • Fax: 718-748-2266

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: JOSEPH DORSTEN
Title or Position: PREIDENT
Credential: DO
Phone: 646-509-7410