MOSHOLU PARK RADIOLOGY PC NPI 1710996509

NPI Information

  • NPI: 1710996509
  • Provider Name: MOSHOLU PARK RADIOLOGY PC
  • Classification: Radiology - 2085B0100X
  • Specialization: Body Imaging
  • Entity Type: Organization
  • Doing Business As: MOSHOLU PARK RADIOLOGY PC
  • Address: MOSHOLU PARK RADIOLOGY PC
    3130 GRAND CONCOURSE STE 1P
    BRONX, NY
    ZIP 10458
  • Phone: (718) 933-6969

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NPI Details

MOSHOLU PARK RADIOLOGY PC is a body imaging radiology in Bronx, NY. The provider is a Radiology doctor of Osteopathy that specializes in Body Imaging. MOSHOLU PARK RADIOLOGY PC NPI is 1710996509. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mosholu Park Radiology Pc.

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 8/22/2020.

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
12085B0100XRadiologyBody Imaging1252131NEW YORKYes
22085N0904XRadiologyNuclear Radiology1252131NEW YORKX
32085U0001XRadiologyDiagnostic Ultrasound1252131NEW YORKX

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
100234428MEDICAIDNEW 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: 3/30/2025

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