Provider Demographics
NPI:1710181102
Name:QUANTUM RADIOLOGY, LLC
Entity Type:Organization
Organization Name:QUANTUM RADIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:SKIBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-584-9582
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-0180
Mailing Address - Country:US
Mailing Address - Phone:518-584-9582
Mailing Address - Fax:815-301-2792
Practice Address - Street 1:12 AMERICA WAY
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6491
Practice Address - Country:US
Practice Address - Phone:518-584-9582
Practice Address - Fax:815-301-2792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21662012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty