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General NPI Number Information
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NPI Number | 1568789055
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Entity Type | Organization
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Legal Business Name | METROPOLITAN DIAGNOSTIC RADIOLOGY, P.C.
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 5106 VERNON BLVD SUITE 203
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5808
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Country | US
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Telephone | 646-713-2992
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Fax | 718-784-6288
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Provider Business Mailing Address
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Address Line | 5106 VERNON BLVD SUITE 203
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5808
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Country | US
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Telephone | 646-713-2992
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Fax | 718-784-6288
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD DENISE
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Credential | M.D.
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Telephone | 917-743-3866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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