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General NPI Number Information
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NPI Number | 1235116179
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Entity Type | Organization
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Legal Business Name | BAB NUCLEAR RADIOLOGY, PC
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 763 LARKFIELD RD
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City | COMMACK
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State | NY
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Zip | 11725-3100
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Country | US
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Telephone | 631-489-5000
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Fax | 631-858-1990
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Provider Business Mailing Address
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Address Line | PO BOX 18005
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City | HAUPPAUGE
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State | NY
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Zip | 11788-8805
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Country | US
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Telephone | 631-517-8000
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Fax | 631-893-1923
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Authorized Official
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Title or Position | SENIOR PARTNER
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Name | DR. PAUL BONHEIM
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Credential | MD
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Telephone | 631-517-8006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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