=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083814594
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUDSON VALLEY DIAGNOSTIC IMAGING, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2007
-----------------------------------------------------
Last Update Date | 07/23/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 310 N HIGHLAND AVE STE 3
-----------------------------------------------------
City | OSSINING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10562-6300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-923-0201
-----------------------------------------------------
Fax | 914-923-0209
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 310 N HIGHLAND AVE STE 3
-----------------------------------------------------
City | OSSINING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10562-6300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-923-0201
-----------------------------------------------------
Fax | 914-923-0209
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/RADIOLOGIST
-----------------------------------------------------
Name | DR. ANDREW M. LEWIS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 914-923-0201
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0200X
-----------------------------------------------------
Taxonomy Name | Radiology Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------