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General NPI Number Information
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NPI Number | 1124414636
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Entity Type | Organization
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Legal Business Name | DARIUS MELISARATOS, MD, RADIOLOGY, PLLC
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 345 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-2244
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Country | US
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Telephone | 718-980-4888
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Fax | 718-980-4873
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Provider Business Mailing Address
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Address Line | 345 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-2244
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Country | US
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Telephone | 718-980-4888
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Fax | 718-980-4873
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Authorized Official
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Title or Position | OWNER
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Name | DARIUS P MELISARATOS
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Credential | M.D.
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Telephone | 516-874-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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