Provider Demographics
NPI:1184104903
Name:MULTICARE MEDICAL DIAGNOSTICS PC
Entity type:Organization
Organization Name:MULTICARE MEDICAL DIAGNOSTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIFTEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-804-6155
Mailing Address - Street 1:225 E 36TH ST # 19FG
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3670
Mailing Address - Country:US
Mailing Address - Phone:877-372-3266
Mailing Address - Fax:877-372-3266
Practice Address - Street 1:13249 41ST RD STE 1B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4286
Practice Address - Country:US
Practice Address - Phone:877-372-3266
Practice Address - Fax:877-372-3266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2197332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty