1518322171 NPI number — QUEENS RADIOLOGY READING SERVICES PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518322171 NPI number — QUEENS RADIOLOGY READING SERVICES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUEENS RADIOLOGY READING SERVICES PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518322171
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16020 79TH ST
Provider Second Line Business Mailing Address:
HOWARD BEACH
Provider Business Mailing Address City Name:
JAMAICA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11414-2911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-344-2855
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16020 79TH ST
Provider Second Line Business Practice Location Address:
HOWARD BEACH
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11414-2911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-344-2855
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
IZZO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
718-344-2855

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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