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General NPI Number Information
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NPI Number | 1528050036
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Entity Type | Organization
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Legal Business Name | MOHAWK VALLEY IMAGING, PC
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 2209 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13501-5930
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Country | US
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Telephone | 315-798-8171
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Fax | 315-734-3084
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Provider Business Mailing Address
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Address Line | 4567 CROSSROADS PARK DR 2ND FLOOR
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City | LIVERPOOL
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State | NY
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Zip | 13088-3589
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Country | US
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Telephone | 315-295-2100
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Fax | 315-295-2125
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | DR. RAPHAEL ALCURI
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Credential | M.D.
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Telephone | 315-798-8171
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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 | 143769
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License Number State | NY
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