Healthcare Provider Details
I. General information
NPI: 1184713109
Provider Name (Legal Business Name): FRANKLIN HOSPITAL RADIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 FRANKLIN AVE
VALLEY STREAM NY
11580-2145
US
IV. Provider business mailing address
PO BOX 33354
HARTFORD CT
06150-3354
US
V. Phone/Fax
- Phone: 800-376-5566
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
ADAMS
Title or Position: MANAGER
Credential:
Phone: 800-376-5566