| NPI | 1235539081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS BROADWAY Owner 917-780-8575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology (Licence: NJ 25MA09187400) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2022-06-30 |