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General NPI Number Information
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NPI Number | 1922517598
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Entity Type | Organization
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Legal Business Name | METROPOLITAN MEDICAL DIAGNOSTICS, PC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 170 E 87TH ST APT E8C
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City | NEW YORK
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State | NY
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Zip | 10128-2256
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Country | US
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Telephone | 631-271-2291
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Fax | 631-277-2825
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Provider Business Mailing Address
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Address Line | 170 E 87TH ST APT E8C
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City | NEW YORK
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State | NY
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Zip | 10128-2256
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Country | US
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Telephone | 914-246-0599
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Fax | 718-791-3162
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | ROSEANN METCALF
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Credential |
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Telephone | 718-698-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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