Healthcare Provider Details

I. General information

NPI: 1043329634
Provider Name (Legal Business Name): OTSEGO MAGNETIC RESONANCE IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FOX CARE DR SUITE 104
ONEONTA NY
13820-2086
US

IV. Provider business mailing address

PO BOX 159
ONEONTA NY
13820-0159
US

V. Phone/Fax

Practice location:
  • Phone: 607-432-8272
  • Fax: 607-432-8274
Mailing address:
  • Phone: 607-432-8272
  • Fax: 607-432-8274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERRI J BEERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 607-432-8272