| NPI | 1780071712 |
|---|---|
| Other Name | 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 | 363L00000X Nurse Practitioner |
| 2085N0904X Radiology, Nuclear Radiology | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2021-10-07 |