| Mount Sinai Elmhurst Faculty Practice Group | |
|
7901 Broadway Rm. A1-19 Elmhurst NY 11373-1329 | |
| (718) 334-4952 | |
| (718) 334-4815 |
| Full Name | Mount Sinai Elmhurst Faculty Practice Group |
|---|---|
| Speciality | Radiology |
| Location | 7901 Broadway, Elmhurst, New York |
| Authorized Official Name and Position | Maria Pilar Gonzalez Jimenez (DIRECTOR FACULTY PRACTICE GROUP) |
| Authorized Official Contact | 7183341591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Sinai Elmhurst Faculty Practice Group 7901 Broadway Rm. A1-19 Elmhurst NY 11373-1329 Ph: (718) 334-4952 | Mount Sinai Elmhurst Faculty Practice Group 7901 Broadway Rm. A1-19 Elmhurst NY 11373-1329 Ph: (718) 334-4952 |
| NPI Number | 1619221686 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 05/10/2016 |
| Medicare PECOS PAC ID | 8224282926 |
|---|---|
| Medicare Enrollment ID | O20201120000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619221686 | NPI | - | NPPES |
| Provider Name | Samuel Nicholas Bone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841216306 PECOS PAC ID: 4880613827 Enrollment ID: I20051118000141 |
| Provider Name | Diane H Conley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528032604 PECOS PAC ID: 1355331273 Enrollment ID: I20090126000191 |
| Provider Name | Neil Leslie Goldberg |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1780625509 PECOS PAC ID: 7911980628 Enrollment ID: I20150108000240 |
| Provider Name | Desiree Lerro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881680791 PECOS PAC ID: 3173424785 Enrollment ID: I20231013000099 |
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