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General NPI Number Information
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NPI Number | 1821108804
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Entity Type | Organization
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Legal Business Name | EMPIRE MEDICAL GROUP OF NEW YORK PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 113-02 QUEENS BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-544-3066
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Fax | 718-544-3125
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Provider Business Mailing Address
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Address Line | 800 LANIDEX PLAZA SUITE 210
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City | PARSIPPANY
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State | NJ
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Zip | 07054
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Country | US
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Telephone | 718-544-3066
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Fax | 718-544-3125
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Authorized Official
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Title or Position | MANAGER
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Name | PAUL TIMOTHY BURNS
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Credential |
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Telephone | 212-818-1555
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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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