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General NPI Number Information
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NPI Number | 1558336420
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Entity Type | Organization
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Legal Business Name | STAND-UP MRI OF EAST ELMHURST, PC
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 7533 31ST AVE
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1811
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Country | US
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Telephone | 718-779-2825
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Fax | 718-779-5349
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Provider Business Mailing Address
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Address Line | 7533 31ST AVE
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1811
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Country | US
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Telephone | 718-779-2825
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Fax | 718-779-5349
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | LLOYD WAXMAN
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Credential |
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Telephone | 631-694-2816
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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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