Provider Demographics
NPI:1659841013
Name:MIDTOWN WEST RADIOLOGY P.C.
Entity Type:Organization
Organization Name:MIDTOWN WEST RADIOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO,
Authorized Official - Phone:929-480-9100
Mailing Address - Street 1:P.O. BOX 21858
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-1858
Mailing Address - Country:US
Mailing Address - Phone:929-480-9100
Mailing Address - Fax:877-888-7955
Practice Address - Street 1:35 SEACOAST TERRACE
Practice Address - Street 2:#20N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:929-480-9100
Practice Address - Fax:877-888-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty