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General NPI Number Information
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NPI Number | 1700879558
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Entity Type | Organization
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Legal Business Name | MAX S LAGUERRE, MD PC
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 5 LYON PL
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City | OGDENSBURG
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State | NY
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Zip | 13669-2586
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Country | US
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Telephone | 315-393-2314
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Fax | 315-393-3873
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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
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Name | DR. MAX S LAGUERRE
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Credential | M.D.
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Telephone | 315-393-2314
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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 | 226230 1
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License Number State | NY
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