Provider Demographics
NPI:1750112512
Name:MCARDLE, KIAH C (RT, RDMS, RDCS)
Entity type:Individual
Prefix:
First Name:KIAH
Middle Name:C
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:RT, RDMS, RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 COLEHAMER AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-7116
Mailing Address - Country:US
Mailing Address - Phone:518-248-7697
Mailing Address - Fax:
Practice Address - Street 1:32 COLEHAMER AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-7116
Practice Address - Country:US
Practice Address - Phone:518-248-7697
Practice Address - Fax:518-205-7057
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1474362085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound