Provider Demographics
NPI:1083748115
Name:LEVITTOWN RADIOLOGICAL SERVICES PSC
Entity Type:Organization
Organization Name:LEVITTOWN RADIOLOGICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIZARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-784-1235
Mailing Address - Street 1:PMB 358 1353
Mailing Address - Street 2:ROAD 19
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-795-4321
Mailing Address - Fax:787-795-4321
Practice Address - Street 1:7MA SECCION LEVITTOWN
Practice Address - Street 2:JR2 CALLE LIZZIE GRAHAM
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-784-1235
Practice Address - Fax:787-795-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR110212085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF87509Medicare UPIN