Organization
EAST QUEENS MEDICAL DIAGNOSTIC SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON J SEWELL M.D. (PRESIDENT)
(718) 276-3400
Entity
Organization
Contact information
Practice address
23011 LINDEN BLVD, CAMBRIA HEIGHTS, NY 11411-1851
(718) 276-3400
(718) 276-3402
Mailing address
230-11 LINDEN BLVD, CAMBRIA HEIGHTS, NY 11411-1851
(718) 276-3400
(718) 276-3402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
179357
NY
2085B0100X
Body Imaging Physician
116260
NY
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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