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General NPI Number Information
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NPI Number | 1144262551
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Entity Type | Organization
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Legal Business Name | UNIVERSITY MEDICAL IMAGING PC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4901 LAC DE VILLE BLVD SUITE 140
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City | ROCHESTER
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State | NY
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Zip | 14618-5647
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Country | US
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Telephone | 585-341-9065
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Fax |
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Provider Business Mailing Address
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Address Line | 4901 LAC DE VILLE BLVD SUITE 140
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City | ROCHESTER
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State | NY
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Zip | 14618-5647
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Country | US
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Telephone | 585-341-9065
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | CHRISTINE M MENKE
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Credential |
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Telephone | 585-275-5969
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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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