Provider Demographics
NPI:1841240603
Name:ORANGE RADIOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ORANGE RADIOLOGY ASSOCIATES, P.C.
Other - Org Name:ORANGE RADIOLOGY AND MRI OF WALLKILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOBROFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-368-5000
Mailing Address - Street 1:320 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3353
Mailing Address - Country:US
Mailing Address - Phone:845-565-1989
Mailing Address - Fax:845-863-0072
Practice Address - Street 1:674 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2644
Practice Address - Country:US
Practice Address - Phone:845-344-4405
Practice Address - Fax:845-344-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350232492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03269147Medicaid
NY00947888Medicaid
NY03269147Medicaid