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Organization

EMPIRE MEDICAL GROUP OF NEW YORK PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL TIMOTHY BURNS (MANAGER)
(212) 818-1555
Entity
Organization

Contact information

Practice address
113-02 QUEENS BLVD, FOREST HILLS, NY 11375
(718) 544-3066
(718) 544-3125
Mailing address
800 LANIDEX PLAZA, SUITE 210, PARSIPPANY, NJ 07054
(718) 544-3066
(718) 544-3125

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07407
GHI MEDICARE PROVIDER ID
NY
Enumeration date
08/30/2006
Last updated
11/04/2015
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