# SOUTHAMPTON RADIOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255349239
- **Authorized official:** MARTIN VANDYNE MD (PRESIDENT)
- **Authorized official phone:** (631) 727-2755

## Contact information

- **Practice address:** 240 MEETING HOUSE LN, SOUTHAMPTON, NY 11968
- **Practice address phone:** (631) 726-8200
- **Practice address fax:** (631) 726-8250
- **Mailing address:** 1333 ROANOKE AVE, RIVERHEAD, NY 11901
- **Mailing address phone:** (631) 727-2755
- **Mailing address fax:** (631) 727-4391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 10/11/2007