Provider Demographics
NPI:1497130579
Name:NOA DIAGNOSTICS OF NY
Entity Type:Organization
Organization Name:NOA DIAGNOSTICS OF NY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:O'SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-655-9254
Mailing Address - Street 1:6851 JERICHO TPKE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4494
Mailing Address - Country:US
Mailing Address - Phone:516-986-2700
Mailing Address - Fax:
Practice Address - Street 1:6851 JERICHO TPKE
Practice Address - Street 2:SUITE 150
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4494
Practice Address - Country:US
Practice Address - Phone:516-986-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29024143335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier