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Organization

ALAN BERLLY, MDPC

Active
Other names
Meadow Diagnostic Imaging
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN BERLLY MD (SENIOR PARTNER)
(631) 517-8006
Entity
Organization

Contact information

Practice address
1854 FRONT ST, EAST MEADOW, NY 11554-2444
(516) 228-0110
(516) 228-0111
Mailing address
PO BOX 18005, HAUPPAUGE, NY 11788-8805
(631) 517-8000
(631) 893-1923

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00730814
NY
Enumeration date
12/29/2005
Last updated
09/14/2007
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