Provider Demographics
NPI:1356112239
Name:MONTROSE RADIOLOGY PLLC
Entity type:Organization
Organization Name:MONTROSE RADIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-252-2609
Mailing Address - Street 1:2233 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3831
Mailing Address - Country:US
Mailing Address - Phone:970-765-0831
Mailing Address - Fax:
Practice Address - Street 1:3330 S RIO GRANDE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-249-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty