Provider Demographics
NPI:1114960853
Name:WINTHROP RADIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:WINTHROP RADIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-663-2123
Mailing Address - Street 1:PO BOX 95000-5560
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-5560
Mailing Address - Country:US
Mailing Address - Phone:866-388-2919
Mailing Address - Fax:866-388-4127
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:RADIOLOGY DEPT
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-2123
Practice Address - Fax:516-663-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01362743Medicaid
NYCC0678Medicare PIN
NYW20461Medicare PIN