Organization
IS RADIOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J LODISPOTO MD (MD/OWNER)
(631) 446-4700
Entity
Organization
Contact information
Practice address
1201 ROUTE 112, PORT JEFFERSON STATION, NY 11776-8001
(631) 446-4700
(631) 446-4701
Mailing address
1201 ROUTE 112, PORT JEFFERSON STATION, NY 11776-8001
(631) 446-4700
(631) 446-4701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
171063
NY
Other
Enumeration date
06/06/2012
Last updated
06/07/2012
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