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General NPI Number Information
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NPI Number | 1275930489
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Entity Type | Organization
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Legal Business Name | FRESH MEADOWS DIAGNOSTIC RADIOLOGY, PC
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 16105 HORACE HARDING EXPY
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City | FLUSHING
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State | NY
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Zip | 11365-1426
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Country | US
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Telephone | 718-359-8700
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Fax | 718-762-0067
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Provider Business Mailing Address
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Address Line | 16105 HORACE HARDING EXPY
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City | FLUSHING
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State | NY
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Zip | 11365-1426
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Country | US
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Telephone | 718-359-8700
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Fax | 718-762-0067
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Authorized Official
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Title or Position | OWNER
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Name | DR. HARVEY LEONARD LEFKOWITZ
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Credential | M.D.
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Telephone | 718-359-8700
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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 | 106140-4
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License Number State | NY
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