Provider Demographics
NPI:1427082676
Name:SOUTHERN WESTCHESTER DIAGNOSTIC IMAGING
Entity type:Organization
Organization Name:SOUTHERN WESTCHESTER DIAGNOSTIC IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAIED
Authorized Official - Middle Name:ISSA
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-309-2517
Mailing Address - Street 1:50 HILLSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703
Mailing Address - Country:US
Mailing Address - Phone:914-309-2517
Mailing Address - Fax:
Practice Address - Street 1:50 HILLSIDE AVENUE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703
Practice Address - Country:US
Practice Address - Phone:914-309-2517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty