Provider Demographics
NPI:1952546905
Name:ARIS TELERADIOLOGY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ARIS TELERADIOLOGY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-655-3800
Mailing Address - Street 1:5655 HUDSON DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4451
Mailing Address - Country:US
Mailing Address - Phone:330-655-3800
Mailing Address - Fax:
Practice Address - Street 1:5655 HUDSON DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4451
Practice Address - Country:US
Practice Address - Phone:330-655-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1237Medicare PIN
NVBG942Medicare PIN