Organization
MARINE PARK RADIOLOGY PC
Active
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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