MEDICARE: FRONTIER RADIOLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1326994211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTIER RADIOLOGY, LLC

Provider Business Mailing Address
First Line	:	8 THE GRN STE R
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19901-3618
Country	:	US
Telephone Number	:	516-458-1853
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 INGOLD DR
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-7804
Country	:	US
Telephone Number	:	516-458-1853
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSHUA EWELL
Credential	:	DO
Telephone Number	:	516-458-1853

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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