Organization
RENAISSANCE MEDICAL IMAGING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DENISE MD (OWNER/PRESIDENT)
(646) 713-2955
Entity
Organization
Contact information
Practice address
5106 VERNON BLVD, STE 204, LONG ISLAND CITY, NY 11101
(646) 713-2955
(877) 888-7955
Mailing address
5106 VERNON BLVD, STE 204, LONG ISLAND CITY, NY 11101
(646) 713-2955
(877) 888-7955
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00922725
—
NY
Enumeration date
03/19/2013
Last updated
05/15/2019
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