Healthcare Provider Details

I. General information

NPI: 1700604659
Provider Name (Legal Business Name): ASSOCIATES IN RADIATION MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11105 CATHAGE RD
BERLIN MD
21811-2131
US

IV. Provider business mailing address

PO BOX 418837
BOSTON MA
02241-8837
US

V. Phone/Fax

Practice location:
  • Phone: 410-912-4966
  • Fax: 410-912-4967
Mailing address:
  • Phone: 888-846-5527
  • Fax: 607-324-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LYNDA LOSECCO
Title or Position: ADMINISTRATOR
Credential:
Phone: 607-324-2340