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General NPI Number Information
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NPI Number | 1992882682
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Entity Type | Organization
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Legal Business Name | KISSENA MEDICAL IMAGING,P.C.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 140-15 HOLLY AVE
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City | FLUSHING
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State | NY
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Zip | 11355-3433
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Country | US
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Telephone | 718-961-1663
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Fax | 718-961-1665
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Provider Business Mailing Address
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Address Line | 14015 HOLLY AVE
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City | FLUSHING
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State | NY
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Zip | 11355-3433
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Country | US
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Telephone | 718-961-1663
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Fax | 718-961-1665
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAWRENCE N DIAMOND
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Credential | M.D.
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Telephone | 718-961-1663
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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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