Provider Demographics
NPI:1558707679
Name:GATEWAY RADIOLOGY CONSULTANTS PA
Entity Type:Organization
Organization Name:GATEWAY RADIOLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAGANDEEP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:MANGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-522-1061
Mailing Address - Street 1:2100 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-1212
Mailing Address - Country:US
Mailing Address - Phone:727-522-1061
Mailing Address - Fax:727-528-7916
Practice Address - Street 1:2100 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1212
Practice Address - Country:US
Practice Address - Phone:727-522-1061
Practice Address - Fax:727-528-7916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty