Organization
TOTAL RADIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIDDHARTH PRAKASH MD (OWNER/PRESIDENT)
(347) 346-8330
Entity
Organization
Contact information
Practice address
3199 BAINBRIDGE AVE, 1ST FL, BRONX, NY 10467-3907
(347) 346-8330
(347) 346-8333
Mailing address
3199 BAINBRIDGE AVE, 1ST FL, BRONX, NY 10467-3907
(347) 346-8330
(347) 346-8333
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03412475
—
NY
Enumeration date
01/03/2012
Last updated
10/23/2014
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