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General NPI Number Information
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NPI Number | 1306137120
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Entity Type | Organization
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Legal Business Name | COMPLETE RADIOLOGY READING SERVICES, PLLC
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 400 POST AVE SUITE 104
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City | WESTBURY
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State | NY
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Zip | 11590-2289
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Country | US
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Telephone | 516-620-9510
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Fax | 516-620-9512
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Provider Business Mailing Address
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Address Line | 400 POST AVE SUITE 104
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City | WESTBURY
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State | NY
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Zip | 11590-2289
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Country | US
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Telephone | 516-620-9510
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Fax | 516-620-9512
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Authorized Official
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Title or Position | CEO
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Name | DR. ALLEN ROTHPEARL
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Credential | M.D.
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Telephone | 516-620-9510
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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 | 179224
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License Number State | NY
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