Provider Demographics
NPI:1487925111
Name:DORSTEN MEDICAL PC
Entity type:Organization
Organization Name:DORSTEN MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:DORSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-509-7410
Mailing Address - Street 1:666 GREENWICH ST
Mailing Address - Street 2:APT 843
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-6329
Mailing Address - Country:US
Mailing Address - Phone:646-509-7410
Mailing Address - Fax:718-748-2266
Practice Address - Street 1:666 GREENWICH ST
Practice Address - Street 2:APT 843
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-6329
Practice Address - Country:US
Practice Address - Phone:646-509-7410
Practice Address - Fax:718-748-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1998352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty