Organization
LEADING EDGE MEDICAL DIAGNOSTIC MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE KHODAK (MANAGER)
(845) 562-4545
Entity
Organization
Contact information
Practice address
290 BROADWAY, STE 1, NEWBURGH, NY 12550-5301
(845) 562-4545
(845) 562-4545
Mailing address
290 BROADWAY STE 1, NEWBURGH, NY 12550-5301
(845) 562-4545
(845) 562-4555
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
09/30/2010
Last updated
06/01/2021
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