Healthcare Provider Details

I. General information

NPI: 1902879141
Provider Name (Legal Business Name): SCHENECTADY RADIOLOGISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2546 BALLTOWN RD SUITE 100
SCHENECTADY NY
12309-1079
US

IV. Provider business mailing address

107 NOTT TER SUITE 100
SCHENECTADY NY
12308-3170
US

V. Phone/Fax

Practice location:
  • Phone: 518-372-1344
  • Fax: 518-372-9848
Mailing address:
  • Phone: 518-372-4405
  • Fax: 518-372-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number156431
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL L BURKE
Title or Position: RADIOLOGIST
Credential: M.D.
Phone: 518-372-4405