Healthcare Provider Details

I. General information

NPI: 1043200439
Provider Name (Legal Business Name): CORINTHIAN DIAGNOSTIC RADIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 EAST 37TH STREET SUITE 204
NEW YORK NY
10016-3256
US

IV. Provider business mailing address

345 EAST 37TH STREET SUITE 204
NEW YORK NY
10016-3256
US

V. Phone/Fax

Practice location:
  • Phone: 212-697-8900
  • Fax: 212-697-8464
Mailing address:
  • Phone: 212-697-8900
  • Fax: 212-697-8464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number1562661
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number156266-1
License Number StateNY

VIII. Authorized Official

Name: DR. LESLIE A SAINT-LOUIS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 212-697-8900