Provider Demographics
NPI:1346645652
Name:SRM RADIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:SRM RADIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-391-3850
Mailing Address - Street 1:639 W END AVE
Mailing Address - Street 2:#PHA
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7343
Mailing Address - Country:US
Mailing Address - Phone:914-391-3850
Mailing Address - Fax:914-934-3472
Practice Address - Street 1:639 W END AVE
Practice Address - Street 2:#PHA
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7343
Practice Address - Country:US
Practice Address - Phone:914-391-3850
Practice Address - Fax:914-934-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty