Provider Demographics
NPI:1376646836
Name:COLUMBIA RADIOLOGY AT LAWRENCE
Entity Type:Organization
Organization Name:COLUMBIA RADIOLOGY AT LAWRENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENTAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LADUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-305-1948
Mailing Address - Street 1:630 W 168TH ST # 28
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-1948
Mailing Address - Fax:212-305-5777
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-9335
Practice Address - Fax:212-305-8636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital