Provider Demographics
NPI:1841483625
Name:WESTCHESTER PET & MEDICAL IMAGING, PC
Entity type:Organization
Organization Name:WESTCHESTER PET & MEDICAL IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEDL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-797-6644
Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-347-3171
Mailing Address - Fax:917-347-3172
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-347-3171
Practice Address - Fax:917-347-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02974770Medicaid
NY02974770Medicaid