Organization
CENTRAL PARK DIAGNOSTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHNOZ RUSTAMOVA M.D. (OWNER)
(212) 974-0490
Entity
Organization
Contact information
Practice address
24111 147TH AVE, ROSEDALE, ROSEDALE, NY 11422-2455
(212) 974-0490
(212) 974-0493
Mailing address
134 W 58TH ST, STE. 102, NEW YORK, NY 10019-2153
(212) 974-0490
(212) 974-0493
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
245082
NY
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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