Provider Demographics
NPI:1790785087
Name:POSTAL, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:POSTAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 ALLENBY DR
Practice Address - Street 2:SUITE 3950
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1421
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2256962085R0202X
MEMD276132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology