Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Feb 7, 2006
License(s)
246302 (NY), 246302 (NY), 246302 (NY), MD067418L (PA), MD067418L (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 120 HICKSVILLE RD | Bethpage, NY 11714-3443 | 516-717-1839 |
| MAILING | 120 HICKSVILLE RD | Bethpage, NY 11714-3443 | 516-717-1839 |
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