| NPI | 1205223294 |
|---|---|
| Doing Business As | SPHPMA RADIOLOGY DIVISION |
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085N0904X |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-04-30 |