Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Mar 9, 2006
License(s)
207426-1 (NY), 207426 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 600 ROE AVE | Elmira, NY 14905-1629 | 607-734-3414 |
| MAILING | 100 E 14TH ST | Elmira Heights, NY 14903-1318 | 607-734-6237 |
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