Basic Information
Provider Information
NPI: 1710208236
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGLIONE
FirstName: KATHARINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2: RADIOLOGY, BOX 1234
City: NEW YORK
State: NY
PostalCode: 100296504
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Practice Location
Address1: 1 GUSTAVE L LEVY PL
Address2: RADIOLOGY, BOX 1234
City: NEW YORK
State: NY
PostalCode: 100296504
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2010
LastUpdateDate: 07/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X2124551NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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