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Individual

DR. JOHN AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-9335
(212) 305-8636
Mailing address
630 W 168TH ST, MC# 28, NEW YORK, NY 10032-3725
(212) 305-1948
(212) 305-5777

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
116390-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00428280
NY
01
02186203
MEDICAID GROUP#
NY
01
W35021
MEDICARE GROUP#
NY
Enumeration date
06/28/2006
Last updated
11/27/2007
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