Provider Demographics
NPI:1881066470
Name:EXCEL RADIOLOGY SERVICES, PC
Entity type:Organization
Organization Name:EXCEL RADIOLOGY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:SOFIA
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-531-9119
Mailing Address - Street 1:1570 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5238
Mailing Address - Country:US
Mailing Address - Phone:516-531-9119
Mailing Address - Fax:516-414-7126
Practice Address - Street 1:1930 VETERANS HWY
Practice Address - Street 2:SUITE 12-220
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1599
Practice Address - Country:US
Practice Address - Phone:516-531-9119
Practice Address - Fax:516-414-7126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176232174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty