# MOSHOLU PARK RADIOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mosholu Park Radiology PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710996509
- **Authorized official:** ANDRESITO B PACIS MD (PRESIDENT)
- **Authorized official phone:** (718) 933-6969

## Contact information

- **Practice address:** MOSHOLU PARK RADIOLOGY PC, 3130 GRAND CONCOURSE STE 1P, BRONX, NY 10458
- **Practice address phone:** (718) 933-6969
- **Practice address fax:** (718) 933-6970
- **Mailing address:** MOSHOLU PARK RADIOLOGY PC, 3130 GRAND CONCOURSE STE 1P, BRONX, NY 10458
- **Mailing address phone:** (718) 933-6969
- **Mailing address fax:** (718) 933-6970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | 1252131 | NY | — |
| 2085N0904X | Nuclear Radiology Physician | 1252131 | NY | Yes |
| 2085U0001X | Diagnostic Ultrasound Physician | 1252131 | NY | — |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 09/11/2025