Provider Demographics
NPI:1093794513
Name:CAPITAL IMAGING ASSOCIATES
Entity Type:Organization
Organization Name:CAPITAL IMAGING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GABOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-785-7373
Mailing Address - Street 1:PO BOX 5247
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-0247
Mailing Address - Country:US
Mailing Address - Phone:518-785-7373
Mailing Address - Fax:518-785-1132
Practice Address - Street 1:1001 LOUDEN
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-5003
Practice Address - Country:US
Practice Address - Phone:518-785-7373
Practice Address - Fax:518-785-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39925AMedicare ID - Type Unspecified