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General NPI Number Information
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NPI Number | 1831901834
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Entity Type | Organization
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Legal Business Name | IMPACT IMAGING LLC
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Dates
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Enumeration Date | 01/25/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1133 WESTCHESTER AVE STE N-010
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City | WHITE PLAINS
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State | NY
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Zip | 10604-3516
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Country | US
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Telephone | 914-475-1055
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Fax | 646-661-2347
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Provider Business Mailing Address
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Address Line | 4 TRAVIS RD
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City | BALDWIN PLACE
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State | NY
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Zip | 10505-2005
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Country | US
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Telephone | 914-475-1055
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Fax | 646-661-2347
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LEE SCOTT MARCUS
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Credential | MD
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Telephone | 914-475-1055
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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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