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General NPI Number Information
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NPI Number | 1710181102
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Entity Type | Organization
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Legal Business Name | QUANTUM RADIOLOGY, LLC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 12 AMERICA WAY
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-6491
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Country | US
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Telephone | 518-584-9582
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Fax | 815-301-2792
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Provider Business Mailing Address
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Address Line | PO BOX 180
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-0180
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Country | US
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Telephone | 518-584-9582
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Fax | 815-301-2792
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORRAINE KATHERINE SKIBO
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Credential | M.D.
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Telephone | 518-584-9582
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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 | 2166201
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License Number State | NY
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