Healthcare Provider Details

I. General information

NPI: 1508816166
Provider Name (Legal Business Name): SUBURBAN MEDICAL IMAGING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 E ROBINSON RD
WEST AMHERST NY
14228-2041
US

IV. Provider business mailing address

55 SPINDRIFT DR
WILLIAMSVILLE NY
14221-7800
US

V. Phone/Fax

Practice location:
  • Phone: 716-633-2880
  • Fax: 716-631-1249
Mailing address:
  • Phone: 716-631-2500
  • Fax: 716-631-1249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JANET H SUNG
Title or Position: PRESIDENT
Credential: MD
Phone: 716-631-2500