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General NPI Number Information
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NPI Number | 1992193007
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Entity Type | Organization
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Legal Business Name | ADVANCED RADIOLOGIC CONCEPTS
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Dates
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Enumeration Date | 12/26/2014
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Last Update Date | 12/26/2014
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Provider Practice Location Address
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Address Line | 211 E 51ST ST
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City | NEW YORK
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State | NY
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Zip | 10022-6526
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Country | US
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Telephone | 212-308-3076
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Fax |
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Provider Business Mailing Address
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Address Line | 2 INDIAN HILL RD
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City | RYE
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State | NY
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Zip | 10580-3510
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Country | US
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Telephone | 212-308-3076
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MAURICE PETERS JR.
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Credential | M.D.
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Telephone | 212-308-3076
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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 | 230031
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License Number State | NY
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