Basic Information
| Provider Information | |||||||||
| NPI: | 1659711653 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PILCH | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.R.A., R.T. (R) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1203 CRESTWYCK CIR | ||||||||
| Address2: | |||||||||
| City: | MOUNT JOY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175527211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099234659 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 FIRST AVENUE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122637300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2013 | ||||||||
| LastUpdateDate: | 07/05/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471C3402X | 438694 | CT | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiography |
No ID Information.