Organization
QUEENS DIAGNOSTIC RADIOLOGY, P.C.
Active
Other names
Queens Diagnostic Radiology, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J LODESPOTO MD (PRESIDENT)
(718) 764-2222
Entity
Organization
Contact information
Practice address
25302 ROCKAWAY BLVD STE B, ROSEDALE, NY 11422-3114
(718) 764-2222
(516) 666-8655
Mailing address
25302 ROCKAWAY BLVD STE B, ROSEDALE, NY 11422-3114
(718) 764-2222
(516) 666-8655
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
171063
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01418331
—
NY
Enumeration date
04/06/2018
Last updated
06/16/2018
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