Healthcare Provider Details
I. General information
NPI: 1144391285
Provider Name (Legal Business Name): MRI ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/12/2006
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
462 GRIDER ST
BUFFALO NY
14215-3021
US
IV. Provider business mailing address
462 GRIDER ST
BUFFALO NY
14215-3021
US
V. Phone/Fax
- Phone: 716-898-3146
- Fax:
- Phone: 716-898-3146
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROVERT
CONTI
Title or Position: PRESIDENT
Credential: MD
Phone: 716-898-3146