Provider Demographics
NPI:1346429404
Name:BEECH IMAGING AND DIAGNOSTIC PC DBA RADIOLOGY IMAGING OF QUEENS
Entity Type:Organization
Organization Name:BEECH IMAGING AND DIAGNOSTIC PC DBA RADIOLOGY IMAGING OF QUEENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHPEARL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-620-9510
Mailing Address - Street 1:6829 SPRINGFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2632
Mailing Address - Country:US
Mailing Address - Phone:718-279-1300
Mailing Address - Fax:
Practice Address - Street 1:6829 SPRINGFIELD BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-2632
Practice Address - Country:US
Practice Address - Phone:718-279-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2085B0100X, 2085D0003X, 2085N0904X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty