Healthcare Provider Details

I. General information

NPI: 1356574826
Provider Name (Legal Business Name): KORANGY RADIOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 YORK RD SUITE 108
COCKEYSVILLE MD
21030-3314
US

IV. Provider business mailing address

PO BOX 5847
BALTIMORE MD
21282-5847
US

V. Phone/Fax

Practice location:
  • Phone: 410-628-6090
  • Fax: 410-628-6190
Mailing address:
  • Phone: 410-764-0912
  • Fax: 443-514-1298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMD

VIII. Authorized Official

Name: MICHAEL S KORANGY
Title or Position: CFO
Credential:
Phone: 410-764-0912