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General NPI Number Information
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NPI Number | 1376545012
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Entity Type | Organization
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Legal Business Name | CENTRAL RADIOLOGY, PC
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 13710 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11354-4122
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Country | US
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Telephone | 718-888-9180
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Fax | 718-888-9260
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Provider Business Mailing Address
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Address Line | 13710 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11354-4122
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Country | US
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Telephone | 718-888-9180
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Fax | 718-888-9260
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY X. HU
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Credential | M.D.
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Telephone | 718-888-9180
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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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