MEDICARE: SCHENECTADY RADIOLOGISTS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	156431	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902879141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHENECTADY RADIOLOGISTS, P.C.

Provider Business Mailing Address
First Line	:	107 NOTT TER
Second Line	:	SUITE 100
City	:	SCHENECTADY
State	:	NY
Zip	:	12308-3170
Country	:	US
Telephone Number	:	518-372-4405
Fax Number	:	518-372-2272

Provider Business Practice Location Address
First Line	:	2546 BALLTOWN RD
Second Line	:	SUITE 100
City	:	SCHENECTADY
State	:	NY
Zip	:	12309-1079
Country	:	US
Telephone Number	:	518-372-1344
Fax Number	:	518-372-9848

Authorized Official
Title or Position	:	RADIOLOGIST
Name	:	DR. MICHAEL L BURKE
Credential	:	M.D.
Telephone Number	:	518-372-4405

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	08/21/2008

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