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General NPI Number Information
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NPI Number | 1063253482
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Entity Type | Organization
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Legal Business Name | LAKE CHAMPLAIN IMAGING PLLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 675 STATE ROUTE 3
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City | PLATTSBURGH
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State | NY
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Zip | 12901-6562
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Country | US
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Telephone | 518-572-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 675 STATE ROUTE 3 STE 105
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City | PLATTSBURGH
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State | NY
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Zip | 12901-6561
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Country | US
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Telephone | 518-699-9729
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Fax | 518-699-9050
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Authorized Official
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Title or Position | MEMBER
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Name | ANTHONY G CONTI
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Credential | M.D.
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Telephone | 518-572-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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