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General NPI Number Information
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NPI Number | 1184732497
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Entity Type | Organization
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Legal Business Name | COLUMBIA RADIOLOGY AT LAWRENCE
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 55 PALMER AVE
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City | BRONXVILLE
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State | NY
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Zip | 10708-3403
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Country | US
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Telephone | 914-787-3058
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Fax | 914-787-3108
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Provider Business Mailing Address
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Address Line | 630 W 168TH ST # 28
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 212-305-1948
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Fax | 212-305-5777
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Authorized Official
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Title or Position | DEPARTMENTAL ADMINISTRATOR
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Name | WILLIAM LADUE
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Credential |
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Telephone | 212-305-1948
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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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