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General NPI Number Information
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NPI Number | 1932489309
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Entity Type | Organization
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Legal Business Name | MAGNETIC RESONANCE IMAGING OF CENTRAL NEW YORK, PLLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 5100 W TAFT RD
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City | LIVERPOOL
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State | NY
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Zip | 13088-3807
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Country | US
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Telephone | 315-452-2525
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Fax | 315-452-2524
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Provider Business Mailing Address
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Address Line | 4567 CROSSROADS PARK DR
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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 | 315-454-4810
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Fax | 315-454-6351
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SCOTT BUCKINGHAM
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Credential | MD
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Telephone | 315-454-4810
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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 | NY
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