Organization
MEADOWS NUCLEAR SPECT IMAGING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE MAYER (VP, MANAGED CARE & CREDENTIALING)
(631) 952-5717
Entity
Organization
Contact information
Practice address
496 SMITHTOWN BYP, SUITE 206, SMITHTOWN, NY 11787-5005
(631) 979-1699
(631) 979-1667
Mailing address
PO BOX 13116, HAUPPAUGE, NY 11788-0556
(631) 979-1699
(631) 979-1667
Taxonomy
Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02082653
—
NY
Enumeration date
11/13/2006
Last updated
08/22/2020
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