Healthcare Provider Details
I. General information
NPI: 1093794513
Provider Name (Legal Business Name): CAPITAL IMAGING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 LOUDEN
COHOES NY
12047-5003
US
IV. Provider business mailing address
PO BOX 5247
ALBANY NY
12205-0247
US
V. Phone/Fax
- Phone: 518-785-7373
- Fax: 518-785-1132
- Phone: 518-785-7373
- Fax: 518-785-1132
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
GABOR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 518-785-7373