Healthcare Provider Details

I. General information

NPI: 1356387294
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF NEW HARTFORD LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 CHAMPLIN AVENUE FAXTON ST LUKES HEALTHCARE
UTICA NY
13502-4830
US

IV. Provider business mailing address

185 GENESEE STREET SUITE 600
UTICA NY
13501-2199
US

V. Phone/Fax

Practice location:
  • Phone: 315-624-6116
  • Fax: 315-624-6318
Mailing address:
  • Phone: 315-793-8806
  • Fax: 315-793-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY A. SILFER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential: MBA, PHD
Phone: 315-793-8806