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General NPI Number Information
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NPI Number | 1881066470
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Entity Type | Organization
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Legal Business Name | EXCEL RADIOLOGY SERVICES, PC
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 1930 VETERANS HWY SUITE 12-220
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City | ISLANDIA
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State | NY
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Zip | 11749-1599
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Country | US
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Telephone | 516-531-9119
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Fax | 516-414-7126
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Provider Business Mailing Address
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Address Line | 1570 OLD COUNTRY RD
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City | WESTBURY
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State | NY
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Zip | 11590-5238
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Country | US
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Telephone | 516-531-9119
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Fax | 516-414-7126
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELE SOFIA RUBIN
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Credential | MD
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Telephone | 516-531-9119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 176232
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License Number State | NY
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