Organization
BETHPAGE MAGNETIC RESONANCE IMAGING, PC
Active
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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