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General NPI Number Information
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NPI Number | 1699441360
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Entity Type | Organization
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Legal Business Name | STAR MEDICAL IMAGING, PC
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 08/21/2021
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Provider Practice Location Address
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Address Line | 141 E MERRICK RD
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5925
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Country | US
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Telephone | 516-604-0707
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Fax | 516-399-1100
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Provider Business Mailing Address
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Address Line | 141 E MERRICK RD
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5925
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Country | US
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Telephone | 516-604-0707
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Fax | 516-399-1100
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JOHN SHERRY LYONS
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Credential | MD
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Telephone | 516-604-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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