Organization
MOSHOLU PARK RADIOLOGY PC
Active
Other names
Mosholu Park Radiology PC
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRESITO B PACIS MD (PRESIDENT)
(718) 933-6969
Entity
Organization
Contact information
Practice address
MOSHOLU PARK RADIOLOGY PC, 3130 GRAND CONCOURSE STE 1P, BRONX, NY 10458
(718) 933-6969
(718) 933-6970
Mailing address
MOSHOLU PARK RADIOLOGY PC, 3130 GRAND CONCOURSE STE 1P, BRONX, NY 10458
(718) 933-6969
(718) 933-6970
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
1252131
NY
2085N0904X
Nuclear Radiology Physician
Primary
1252131
NY
2085U0001X
Diagnostic Ultrasound Physician
1252131
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00234428
—
NY
Enumeration date
08/08/2006
Last updated
09/11/2025
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