MEDICARE: ADIRONDACK RADIOLOGY ASSOCIATES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician
2	2085U0001X	Diagnostic Ultrasound Physician
3	2085R0202X	Diagnostic Radiology Physician	207891	NY

General Provider Information

NPI Number	:	1053673277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADIRONDACK RADIOLOGY ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	PO BOX 985
Second Line	:
City	:	GLENS FALLS
State	:	NY
Zip	:	12801-0985
Country	:	US
Telephone Number	:	518-793-1000
Fax Number	:	518-793-1976

Provider Business Practice Location Address
First Line	:	3 CARE LN
Second Line	:	SUITE 100
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8639
Country	:	US
Telephone Number	:	518-587-7773
Fax Number	:	518-793-1976

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	MS. JUDITH BERNARD
Credential	:
Telephone Number	:	518-793-1000

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	05/23/2024

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