Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 18, 2008
License(s)
277402 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3 EDMUND D PELLEGRINO RD | Stony Brook, NY 11794-8206 | 718-594-7809 |
| MAILING | 19326 MCLAUGHLIN AVE | Hollis, NY 11423-1148 | 888-869-7846 |
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