Healthcare Provider Details

I. General information

NPI: 1881610186
Provider Name (Legal Business Name): NEW YORK DIAGNOSTIC CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SEAFIELD LN
WESTHAMPTON BEACH NY
11978-2714
US

IV. Provider business mailing address

PO BOX 614
WESTHAMPTON BEACH NY
11978-0614
US

V. Phone/Fax

Practice location:
  • Phone: 631-288-1122
  • Fax: 631-288-1638
Mailing address:
  • Phone: 631-288-1113
  • Fax: 631-288-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN C HALEY
Title or Position: PRESIDENT
Credential:
Phone: 631-288-1122