Basic Information
| Provider Information | |||||||||
| NPI: | 1326198334 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUND SHORE RADIOLOGY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 188 | ||||||||
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| City: | LANDISVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175380188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146371357 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16 GUION PL | ||||||||
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| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108015503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146325000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 10/10/2007 | ||||||||
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| AuthorizedOfficialLastName: | LANDY | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9146371357 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SOUND SHORE MEDICAL CENTER | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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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.