Provider Demographics
NPI:1073875282
Name:ADIRONDACK RADIOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:ADIRONDACK RADIOLOGY ASSOCIATES, PC
Other - Org Name:ADVANCED IMAGING AT BAYBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SABLICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-793-1000
Mailing Address - Street 1:PO BOX 985
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-0985
Mailing Address - Country:US
Mailing Address - Phone:518-793-1000
Mailing Address - Fax:518-793-1976
Practice Address - Street 1:25 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5882
Practice Address - Country:US
Practice Address - Phone:518-926-7002
Practice Address - Fax:518-793-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085B0100X, 2085R0202X
NY1913802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty