Healthcare Provider Details

I. General information

NPI: 1063230902
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: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30077 BUSINESS CENTER DR
CHARLOTTE HALL MD
20622-3101
US

IV. Provider business mailing address

PO BOX 418837
BOSTON MA
02241-8837
US

V. Phone/Fax

Practice location:
  • Phone: 301-884-2508
  • Fax: 301-884-2476
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