Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 5, 2021
License(s)
344943 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 475 SEAVIEW AVE | Staten Island, NY 10305-3436 | |
| LOCATION | 475 SEAVIEW AVE | Staten Island, NY 10305-3436 | 718-207-0121 |
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