Provider profile · NPI 1710186903

113th Street Medical Group, Pc

Radiology, Diagnostic Radiology · Forest Hills, NY · NPI 1710186903 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Radiology, Diagnostic Radiology

Enumerated

Jul 17, 2007

License(s)

Addresses on file

PurposeAddressCity/StatePhone
MAILING7035 113TH ST Forest Hills, NY 11375-4651718-990-4255
LOCATION7035 113TH ST Forest Hills, NY 11375-4651718-990-4255

View on NPPES registry ↗

Watch this provider

Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.