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General NPI Number Information
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NPI Number | 1548332935
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Entity Type | Organization
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Legal Business Name | HILLSIDE RADIOLOGY
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16403 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4140
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Country | US
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Telephone | 718-298-6739
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Fax | 718-298-6789
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Provider Business Mailing Address
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Address Line | 16403 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. ZOYA MAKSUMOVA
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Credential | M.D.
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Telephone | 718-298-6739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 200740
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License Number State | NY
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