Provider Demographics
NPI:1669512406
Name:PARKWAY RADIOLOGY, PC
Entity type:Organization
Organization Name:PARKWAY RADIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BALDASAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-368-2800
Mailing Address - Street 1:PO BOX 551
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-0551
Mailing Address - Country:US
Mailing Address - Phone:201-845-4553
Mailing Address - Fax:201-712-1780
Practice Address - Street 1:7035 113TH ST
Practice Address - Street 2:AT PARKWAY HOSPITAL
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4651
Practice Address - Country:US
Practice Address - Phone:718-368-2800
Practice Address - Fax:718-368-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty