MOSHOLU PARK RADIOLOGY PC NPI 1710996509

NPI Information

NPI: 1710996509
Provider Name: MOSHOLU PARK RADIOLOGY PC
Classification: Radiology - 2085N0904X
Specialization: Nuclear Radiology
Entity Type: Organization
:
Address: MOSHOLU PARK RADIOLOGY PC
3130 GRAND CONCOURSE STE 1P
BRONX, NY
ZIP 10458
Phone: (718) 933-6969

Map and Directions

Get Directions

NPI Details

MOSHOLU PARK RADIOLOGY PC is a nuclear radiology radiology in Bronx, NY. The provider is a radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. MOSHOLU PARK RADIOLOGY PC NPI is 1710996509. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

MOSHOLU PARK RADIOLOGY PC
3130 GRAND CONCOURSE STE 1P
BRONX, NY
ZIP 10458
Phone: (718) 933-6969
Fax: (718) 933-6970

The provider's authorized official is Andresito B Pacis .
The authorized official title is President and has the following contact phone number (718) 933-6969.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	1252131	NEW YORK	No
2	2085U0001X	Radiology	Diagnostic Ultrasound	1252131	NEW YORK	No
3	2085N0904X	Radiology	Nuclear Radiology	1252131	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00234428	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI