Organization
STAND-UP MRI OF MANHATTAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD S WAGNER M.D. (OWNER)
(631) 694-2816
Entity
Organization
Contact information
Practice address
191 AVENUE A, NEW YORK, NY 10009-4094
(212) 674-8300
(212) 674-8828
Mailing address
110 MARCUS DRIVE, MELVILLE, NY 11747-4228
(631) 390-1667
(631) 390-1780
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03175380
—
NY
Enumeration date
08/06/2009
Last updated
07/07/2022
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