Provider Demographics
NPI:1376522599
Name:M Y RADIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:M Y RADIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:DIPIETRO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-849-5700
Mailing Address - Street 1:PO BOX 3057
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-0057
Mailing Address - Country:US
Mailing Address - Phone:717-843-0736
Mailing Address - Fax:717-852-0561
Practice Address - Street 1:2064 SPRINGWOOD RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4835
Practice Address - Country:US
Practice Address - Phone:717-843-0736
Practice Address - Fax:717-852-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
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
PA00111539Medicaid
PA154050Medicare ID - Type Unspecified