Healthcare Provider Details

I. General information

NPI: 1518998137
Provider Name (Legal Business Name): NYMHC FPP RADIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE SUITE 5 SOUTH 2 METROPOLITAN HOSPITAL FPP
NEW YORK NY
10029-7404
US

IV. Provider business mailing address

1901 1ST AVE SUITE 5 SOUTH 2 METROPOLITAN HOSPITAL FPP
NEW YORK NY
10029-7404
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-7095
  • Fax: 212-423-8478
Mailing address:
  • Phone: 212-423-7095
  • Fax: 212-423-8478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA PALAZZOTTO
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 212-423-7095