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General NPI Number Information
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NPI Number | 1689745226
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Entity Type | Organization
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Legal Business Name | ROCKLAND NUCLEAR SPECT IMAGING, PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 310 FULLERTON AVE
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City | NEWBURGH
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State | NY
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Zip | 12550-3724
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Country | US
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Telephone | 845-565-9086
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Fax | 845-565-9872
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Provider Business Mailing Address
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Address Line | PO BOX 13125
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City | HAUPPAUGE
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State | NY
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Zip | 11788-0560
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Country | US
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Telephone | 845-565-9086
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Fax | 845-565-9872
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Authorized Official
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Title or Position | VP MANAGED CARE & CREDENTIALING
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Name | JACQUELINE MAYER
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Credential |
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Telephone | 631-952-5717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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