Provider Demographics
NPI:1922051630
Name:EAST MANHATTAN DIAGNOSTIC IMAGING, P.C.
Entity Type:Organization
Organization Name:EAST MANHATTAN DIAGNOSTIC IMAGING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-830-3122
Mailing Address - Street 1:PO BOX 10270
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11555-0270
Mailing Address - Country:US
Mailing Address - Phone:201-830-3122
Mailing Address - Fax:201-200-0838
Practice Address - Street 1:424 E 89TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6703
Practice Address - Country:US
Practice Address - Phone:212-410-5100
Practice Address - Fax:212-410-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5516341OtherFIRSTHEALTH
NYNY419OtherONE CALL MEDICAL
NY1425155OtherUNITED HEALTHCARE
NYW1L822OtherEMPIRE BLUE CROSS BLUE SH
NY4C8838OtherHEALTHNET
NYC51294OtherAMERIHEALTH
NY03235201Medicaid
NY4199993OtherGHI
NY5481603OtherAETNA US HEALTHCARE
NY959OtherCARECORE NATIONAL
NY189300OtherWELLCARE
NYA3184823OtherOXFORD HEALTH PLAN
NYCD5054OtherPALMETTO GBA
NYS23958OtherAMERICAN IMAGING MGNT
NY03235201Medicaid
NYNY419OtherONE CALL MEDICAL