Organization
MARINE PARK RADIOLOGY PC
Active
Other names
Brooklyn Medical Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALFREDO C. ROQUE MD (MEDICAL DIRECTOR)
(718) 375-6000
Entity
Organization
Contact information
Practice address
450 AVENUE P, BROOKLYN, NY 11223-1902
(718) 375-6000
(718) 375-6576
Mailing address
PO BOX 13245, HAUPPAUGE, NY 11788-0840
(631) 952-5701
(631) 952-5740
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02358643
—
NY
Enumeration date
02/02/2007
Last updated
05/06/2008
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