Provider Demographics
NPI:1952496325
Name:RADIOTHERAPY ASSOCIATES OF AUBURN PC
Entity Type:Organization
Organization Name:RADIOTHERAPY ASSOCIATES OF AUBURN PC
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 1:306 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021
Mailing Address - Country:US
Mailing Address - Phone:315-255-3461
Mailing Address - Fax:315-255-3463
Practice Address - Street 1:306 GRANT AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021
Practice Address - Country:US
Practice Address - Phone:315-255-3461
Practice Address - Fax:315-255-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
51030AMedicare PIN