Provider Demographics
NPI:1831423094
Name:CONCOURSE DIAGNOSTIC INC
Entity type:Organization
Organization Name:CONCOURSE DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-809-0097
Mailing Address - Street 1:1963 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4994
Mailing Address - Country:US
Mailing Address - Phone:718-731-2500
Mailing Address - Fax:347-402-8687
Practice Address - Street 1:1963 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4994
Practice Address - Country:US
Practice Address - Phone:718-731-2500
Practice Address - Fax:347-402-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)