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General NPI Number Information
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NPI Number | 1700060365
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Entity Type | Organization
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Legal Business Name | BEECH IMAGING DIAGNOSTIC PC DBA RADIOLOGY IMAGING OF QUEENS
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 6829 SPRINGFILED BLVD
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City | OKLAND GARDENS
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State | NY
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Zip | 11364-0000
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Country | US
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Telephone | 718-279-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 MARCUS AVE STE W83
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1035
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Country | US
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Telephone | 516-620-9510
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Fax |
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Authorized Official
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Title or Position | RADIOLOGYST
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Name | DR. ALLEN ROTHPEARL
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Credential | MD
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Telephone | 718-279-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 179
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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