| NPI | 1528651015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-10-07 |