Organization
PENINSULA RADIOLOGY ASSOCIATES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY SPRECHER M.D. (PARTNER)
(718) 734-2616
Entity
Organization
Contact information
Practice address
5115 BEACH CHANNEL DR, FAR ROCKAWAY, NY 11691-1042
(718) 734-2616
(212) 563-0605
Mailing address
80 MARCUS DR, ATTN: PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-8366
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01470864
—
NY
Enumeration date
08/09/2006
Last updated
05/05/2010
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