Provider Demographics
NPI:1730118910
Name:BIOPATH RAD HOLDINGS LLC
Entity Type:Organization
Organization Name:BIOPATH RAD HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-480-9100
Mailing Address - Street 1:101 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3943
Mailing Address - Country:US
Mailing Address - Phone:718-594-1001
Mailing Address - Fax:
Practice Address - Street 1:2820 N ONTARIO ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2015
Practice Address - Country:US
Practice Address - Phone:718-594-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87208335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31776ZMedicare ID - Type UnspecifiedCA NORTH
CAR055267Medicare ID - Type Unspecified