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General NPI Number Information
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NPI Number | 1912838954
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Entity Type | Organization
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Legal Business Name | BX DIAGNOSTICS
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Dates
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Enumeration Date | 05/28/2026
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Last Update Date | 05/28/2026
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Provider Practice Location Address
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Address Line | 11 RALPH PL STE 308
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City | STATEN ISLAND
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State | NY
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Zip | 10304-4416
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Country | US
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Telephone | 718-853-6433
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Fax |
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Provider Business Mailing Address
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Address Line | 11 RALPH PL STE 308
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City | STATEN ISLAND
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State | NY
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Zip | 10304-4416
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JEREMY MINKOWITZ
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Credential | DO
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Telephone | 718-213-7076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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