Healthcare Provider Details

I. General information

NPI: 1336131598
Provider Name (Legal Business Name): TROY RADIATION ONCOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 BURDETT AVE SAMARITAN CANCER CARE CENTER
TROY NY
12180-2466
US

IV. Provider business mailing address

PO BOX 8701 TROY RADIATION ONCOLOGY
ALBANY NY
12208-0701
US

V. Phone/Fax

Practice location:
  • Phone: 518-271-3220
  • Fax:
Mailing address:
  • Phone: 518-271-3220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SARADA M REDDY
Title or Position: PRESIDENT
Credential: MD
Phone: 518-271-3220