Provider Demographics
NPI:1669676920
Name:NEW IMAGING & DIAGNOSTICS SERVICES, P.C
Entity Type:Organization
Organization Name:NEW IMAGING & DIAGNOSTICS SERVICES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MOREHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-862-3760
Mailing Address - Street 1:2055 WILLIAMSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1606
Mailing Address - Country:US
Mailing Address - Phone:718-862-3760
Mailing Address - Fax:718-824-3113
Practice Address - Street 1:2055 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1606
Practice Address - Country:US
Practice Address - Phone:718-862-3760
Practice Address - Fax:718-824-3113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120775-1261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2155833Medicaid
NY18V571Medicare ID - Type UnspecifiedMEDICARE