Healthcare Provider Details

I. General information

NPI: 1326083239
Provider Name (Legal Business Name): ULSTER RADIOLOGIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 MARYS AVE
KINGSTON NY
12401
US

IV. Provider business mailing address

PO BOX 2270
KINGSTON NY
12402-2270
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-2500
  • Fax:
Mailing address:
  • Phone: 845-339-7582
  • Fax: 845-338-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN DANIEL SCHWARTZ
Title or Position: PRESIDENT
Credential: MD
Phone: 845-340-4500