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General NPI Number Information
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NPI Number | 1598904120
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC PLUS MEDICAL, P.C.
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 6555 WOODHAVEN BLVD LOWER LEVEL
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City | REGO PARK
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State | NY
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Zip | 11374-5048
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Country | US
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Telephone | 718-897-6700
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Fax | 718-897-6711
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Provider Business Mailing Address
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Address Line | 6555 WOODHAVEN BLVD LOWER LEVEL
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City | REGO PARK
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State | NY
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Zip | 11374-5048
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Country | US
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Telephone | 718-897-6700
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Fax | 718-897-6711
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANI USHYAROV
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Credential | D.O.
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Telephone | 718-897-6700
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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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