Organization
MAIN STREET RADIOLOGY AT BAYSIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARI JONISCH M.D. (OFFICER)
(718) 428-1500
Entity
Organization
Contact information
Practice address
4401 FRANCIS LEWIS BLVD, BAYSIDE, NY 11361-3002
(718) 428-1500
(718) 352-0292
Mailing address
3211 FRANCIS LEWIS BLVD, FLUSHING, NY 11358-1922
(718) 352-9850
(718) 352-0102
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02217256
—
NY
Enumeration date
10/10/2006
Last updated
11/03/2022
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