Healthcare Provider Details

I. General information

NPI: 1679621338
Provider Name (Legal Business Name): NEW YORK RADIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E SUITE 3P DEPT OF RADIOLOGY
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

PO BOX 95000-2429
PHILADELPHIA PA
19195-2429
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8880
  • Fax:
Mailing address:
  • Phone: 201-830-3122
  • Fax: 201-200-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ABIRI
Title or Position: CHAIRMAN
Credential: MD
Phone: 201-830-3122