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General NPI Number Information
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NPI Number | 1346645652
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Entity Type | Organization
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Legal Business Name | SRM RADIOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 639 W END AVE #PHA
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City | NEW YORK
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State | NY
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Zip | 10025-7343
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Country | US
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Telephone | 914-391-3850
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Fax | 914-934-3472
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Provider Business Mailing Address
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Address Line | 639 W END AVE #PHA
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City | NEW YORK
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State | NY
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Zip | 10025-7343
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Country | US
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Telephone | 914-391-3850
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Fax | 914-934-3472
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Authorized Official
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Title or Position | MD/DIRECTOR
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Name | MR. MICHAEL SHAPIRO
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Credential | MD
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Telephone | 914-391-3850
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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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