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General NPI Number Information
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NPI Number | 1255323416
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Entity Type | Organization
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Legal Business Name | SCHENECTADY RADIATION ONCOLOGY LLC
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1101 NOTT ST DEPT RADIATION ONCOLOGY
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City | SCHENECTADY
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State | NY
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Zip | 12308-2425
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Country | US
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Telephone | 518-243-4317
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9036 SCHENECTADY RADIATION ONCOLOGY LLC
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City | SCHENECTADY
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State | NY
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Zip | 12309-0036
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Country | US
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Telephone | 518-243-4317
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT J SMITH
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Credential | MD
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Telephone | 518-243-4317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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