Organization
EMPIRE MEDICAL GROUP OF NEW YORK PC
Active
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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