Basic Information
| Provider Information | |||||||||
| NPI: | 1316922248 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALBANY ADVANCED IMAGING PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 74 | ||||||||
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| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121100074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187861299 | ||||||||
| FaxNumber: | 5187861293 | ||||||||
| Practice Location | |||||||||
| Address1: | 648 PLANK RD | ||||||||
| Address2: | |||||||||
| City: | CLIFTON PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120652062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186881177 | ||||||||
| FaxNumber: | 5186881199 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2005 | ||||||||
| LastUpdateDate: | 05/18/2015 | ||||||||
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| AuthorizedOfficialLastName: | RAPOPORT | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5186881177 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.