Provider Demographics
NPI:1700060365
Name:BEECH IMAGING DIAGNOSTIC PC DBA RADIOLOGY IMAGING OF QUEENS
Entity Type:Organization
Organization Name:BEECH IMAGING DIAGNOSTIC PC DBA RADIOLOGY IMAGING OF QUEENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGYST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHPEARL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-279-1300
Mailing Address - Street 1:2001 MARCUS AVE STE W83
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1035
Mailing Address - Country:US
Mailing Address - Phone:516-620-9510
Mailing Address - Fax:
Practice Address - Street 1:6829 SPRINGFILED BLVD
Practice Address - Street 2:
Practice Address - City:OKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-0000
Practice Address - Country:US
Practice Address - Phone:718-279-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1792085B0100X
2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty