Organization
HAMPTON RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN VANDYNE MD (PRESIDENT)
(631) 727-2755
Entity
Organization
Contact information
Practice address
182 WEST MONTAUK HWY, HAMPTON BAYS, NY 11946
(631) 723-1232
(631) 723-1268
Mailing address
1333 ROANOKE AVE, RIVERHEAD, NY 11901
(631) 727-2755
(631) 208-9521
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02705420
—
NY
01
—
DC9356
RR MEDICARE
NY
Enumeration date
08/04/2006
Last updated
04/20/2008
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