Healthcare Provider Details

I. General information

NPI: 1891789939
Provider Name (Legal Business Name): K&A RADIOLOGIC TECHNOLOGY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 COLLAMER ROAD
EAST SYRACUSE NY
13057-1032
US

IV. Provider business mailing address

6400 COLLAMER ROAD
EAST SYRACUSE NY
13057-1032
US

V. Phone/Fax

Practice location:
  • Phone: 315-437-1622
  • Fax: 315-437-3190
Mailing address:
  • Phone: 315-437-1622
  • Fax: 315-437-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH C ANDREWS
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 315-437-1622