Organization
WEST SIDE RADIOLOGY ASSOCIATES, P.C.
Active
Parent organization
WEST SIDE RADIOLOGY ASSOCIATES, P.C.
Other names
St. Lukes Roosvelt Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST SIDE RADIOLOGY ASSOCIATES, P.C.
Authorized official
JEANNE BAER (PRESIDENT)
(201) 830-3122
Entity
Organization
Contact information
Practice address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-4699
Mailing address
PO BOX 10268, UNIONDALE, NY 11555-0268
(201) 830-3122
(201) 200-0838
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085R0205X
Radiological Physics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00418960
—
NY
Enumeration date
01/05/2007
Last updated
12/28/2007
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