Provider Demographics
NPI:1568789055
Name:METROPOLITAN DIAGNOSTIC RADIOLOGY, P.C.
Entity Type:Organization
Organization Name:METROPOLITAN DIAGNOSTIC RADIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DENISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-743-3866
Mailing Address - Street 1:5106 VERNON BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5808
Mailing Address - Country:US
Mailing Address - Phone:646-713-2992
Mailing Address - Fax:718-784-6288
Practice Address - Street 1:5106 VERNON BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5808
Practice Address - Country:US
Practice Address - Phone:646-713-2992
Practice Address - Fax:718-784-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty