Basic Information
| Provider Information | |||||||||
| NPI: | 1275705840 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHELSEA DIAGNOSTIC RADIOLOGY ,P.C | ||||||||
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| OtherOrganizationName: | DBA DIADGNOSTIC RADIOLOGY ASSOC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 W 17TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100115325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129898999 | ||||||||
| FaxNumber: | 9146812906 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 W 17TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100115325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129898999 | ||||||||
| FaxNumber: | 9146812906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2008 | ||||||||
| LastUpdateDate: | 06/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | DONOVAN | ||||||||
| AuthorizedOfficialFirstName: | CARMEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2129898999 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.