Healthcare Provider Details

I. General information

NPI: 1518288133
Provider Name (Legal Business Name): IMAGING ASSOCIATES OF NY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11404 BEACH CHANNEL DR
ROCKAWAY PARK NY
11694-2211
US

IV. Provider business mailing address

545 ELMONT RD
ELMONT NY
11003-4002
US

V. Phone/Fax

Practice location:
  • Phone: 718-318-9729
  • Fax: 718-318-6353
Mailing address:
  • Phone: 516-354-4200
  • Fax: 516-977-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number219543
License Number StateNY

VIII. Authorized Official

Name: DR. DANIEL E BEYDA
Title or Position: PARTNER
Credential: M.D.
Phone: 516-328-7200