Valleystream Radiology PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

120848 Issued in NY

Legal business name

VALLEYSTREAM RADIOLOGY PC

Practice address

234 W Merrick Rd
Valley Stream, NY 11580-5532

Phone

(516) 561-5570

NPI assigned

Aug 10, 2009

Last updated

Aug 11, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Green, M.D.

Title

MD

Phone

(516) 561-5570

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1497987499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520391",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113520391",
            "telephone_number": "516-561-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 W MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805532",
            "telephone_number": "516-561-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEYSTREAM RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "516-561-5570",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "120848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01549628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Stream RX Inc
• Valley Stream Ufsd #24
• Valley Stream Ufsd 13
• Valley Stream Ufsd 30
• Valley Vision Corp
• Value Based Medicine C PC
• Value Based Medicine D PC
• Dianne S Van Dunk
• Desiree Angela Van Sluytman, LPN
• Julie N Van-Lare, NP

• Specialist in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.