Organization
BETHPAGE MAGNETIC RESONANCE IMAGING, PC
Active
Other names
Bethpage Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE MAYER (VP, MANAGED CARE & CREDENTIALING)
(516) 579-8500
Entity
Organization
Contact information
Practice address
4277 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5709
(516) 579-8500
(516) 579-5974
Mailing address
PO BOX 11295, HAUPPAUGE, NY 11788-0973
(516) 579-8500
(516) 579-5974
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235841
—
NY
Enumeration date
11/27/2006
Last updated
07/21/2008
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