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General NPI Number Information
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NPI Number | 1679756944
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Entity Type | Organization
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Legal Business Name | QUEENS RADIOLOGY, PC
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 2308 30TH AVE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11102-3255
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Country | US
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Telephone | 718-726-2000
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Fax | 845-362-6773
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Provider Business Mailing Address
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Address Line | 2308 30TH AVE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11102-3255
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Country | US
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Telephone | 718-726-2000
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Fax | 845-362-6773
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DANIEL SCHLUSSELBERG
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Credential | MD
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Telephone | 845-362-0408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State | NY
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Taxonomy #2
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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 | NY
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