Provider Demographics
NPI:1821183294
Name:NORTH MEDICAL RADIOTHERAPY, P.C.
Entity Type:Organization
Organization Name:NORTH MEDICAL RADIOTHERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:DALOPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-474-4475
Mailing Address - Street 1:815 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2504
Mailing Address - Country:US
Mailing Address - Phone:315-474-4475
Mailing Address - Fax:
Practice Address - Street 1:5116 W TAFT ROAD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088
Practice Address - Country:US
Practice Address - Phone:315-474-4475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
53725AMedicare PIN