Organization
SOUTH NASSAU RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN LASTIG M.D. (DIRECTOR)
(516) 632-4656
Entity
Organization
Contact information
Practice address
1 HEALTHY WAY, ATTN: RADIOLOGY, OCEANSIDE, NY 11572-1551
(516) 632-4656
Mailing address
PO BOX 5768, HICKSVILLE, NY 11802-5768
(516) 632-4656
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01911971
—
NY
Enumeration date
10/25/2005
Last updated
12/06/2007
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