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General NPI Number Information
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NPI Number | 1740353838
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Entity Type | Organization
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Legal Business Name | RADIOLOGY SERVICES OF NEW YORK, PC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1946 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3520
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Country | US
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Telephone | 718-420-2220
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Fax | 718-420-3602
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | MOORESTOWN
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State | NJ
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Zip | 08057-0727
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Country | US
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Telephone | 856-234-5304
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Fax | 856-234-5426
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANN CANINO
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Credential |
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Telephone | 718-420-2220
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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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