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General NPI Number Information
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NPI Number | 1184852741
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Entity Type | Organization
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Legal Business Name | MADISON AVENUE RADIOLOGY PC
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 06/22/2009
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Provider Practice Location Address
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Address Line | 1825 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-3829
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Country | US
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Telephone | 212-860-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 22 MERIDIAN RD STE 7
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City | EDISON
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State | NJ
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Zip | 08820-2860
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SATISH CHANDRA
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Credential | MD
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Telephone | 212-860-3500
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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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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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