Provider Demographics
NPI:1316149560
Name:DIAGNOSTIC RADIOLOGY FOR WOMEN PC
Entity type:Organization
Organization Name:DIAGNOSTIC RADIOLOGY FOR WOMEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-637-8331
Mailing Address - Street 1:170-17 NORTHERN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358
Mailing Address - Country:US
Mailing Address - Phone:646-637-8331
Mailing Address - Fax:718-539-4021
Practice Address - Street 1:170-17 NORTHERN BOULEVARD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358
Practice Address - Country:US
Practice Address - Phone:646-637-8331
Practice Address - Fax:718-539-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2393972085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty