Provider Demographics
NPI:1730334749
Name:ALBANY ADVANCED IMAGING PLLC
Entity type:Organization
Organization Name:ALBANY ADVANCED IMAGING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPOPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-786-1299
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0074
Mailing Address - Country:US
Mailing Address - Phone:518-786-1299
Mailing Address - Fax:518-786-1293
Practice Address - Street 1:199 WOLF RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5945
Practice Address - Country:US
Practice Address - Phone:518-435-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100000061Medicare PIN