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General NPI Number Information
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NPI Number | 1174537948
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Entity Type | Organization
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Legal Business Name | INTEGRATED DIAGNOSTIC IMAGING & CARDIOLOGY OF STATEN ISLAND P.C.
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 2052 RICHMOND RD STE B
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2583
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Country | US
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Telephone | 201-888-7877
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Fax | 855-420-5931
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Provider Business Mailing Address
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Address Line | 2052 RICHMOND RD STE B
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2583
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Country | US
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Telephone | 201-888-7877
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Fax | 855-420-5931
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Authorized Official
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Title or Position | OWNER
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Name | JOHN EDWARD STROBECK
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Credential | MD
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Telephone | 201-888-7877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 1306831
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License Number State | NY
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Taxonomy #2
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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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