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General NPI Number Information
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NPI Number | 1194985762
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Entity Type | Organization
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Legal Business Name | AMERICAN DIAGNOSTICS MEDICAL PLLC
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 775 PARK AVE STE 360
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City | HUNTINGTON
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State | NY
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Zip | 11743-7570
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Country | US
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Telephone | 631-421-1314
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Fax |
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Provider Business Mailing Address
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Address Line | 775 PARK AVE STE 360
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City | HUNTINGTON
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State | NY
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Zip | 11743-7570
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Country | US
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Telephone | 631-421-1314
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JONATHAN ZELEN
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Credential | M.D.
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Telephone | 631-421-1314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 221756
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 175751
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 177819
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License Number State | NY
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