Healthcare Provider Details

I. General information

NPI: 1013946383
Provider Name (Legal Business Name): MILL BASIN RADIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 GREENWICH ST
NEW YORK NY
10013-3386
US

IV. Provider business mailing address

311 GREENWICH ST
NEW YORK NY
10013-3386
US

V. Phone/Fax

Practice location:
  • Phone: 516-557-2545
  • Fax: 516-557-2548
Mailing address:
  • Phone: 516-557-2545
  • Fax: 516-557-2548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number140440-1
License Number StateNY

VIII. Authorized Official

Name: CLIFFORD BEINART
Title or Position: OWNER
Credential: MD
Phone: 212-732-1886