Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jul 17, 2006
License(s)
265228 (NY), 4301063585 (MI), 54888 (CT)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 11800 E TWELVE MILE ROAD | Warren, MI 48093 | 586-573-5060 |
| LOCATION | 2800 MARCUS AVE | New Hyde Park, NY 11042-1113 | 516-622-6100 |
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