Organization
BRONX MEDICAL DIAGNOSTIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JOSEPH LODESPOTO M.D. (MEDICAL DIRECTOR)
(718) 764-5000
Entity
Organization
Contact information
Practice address
3117 BUHRE AVE, BRONX, NY 10461-4799
(718) 764-5000
(718) 239-6308
Mailing address
3117 BUHRE AVE, BRONX, NY 10461-4738
(718) 764-5000
(718) 239-6308
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
11/11/2010
Last updated
02/10/2012
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