Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 30, 2014
License(s)
0101277076 (VA), 303486 (NY), MD483387 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 601 MEMORY LN | York, PA 17402-2231 | 717-851-1405 |
| LOCATION | 111 N MAPLEMERE RD STE 120 | Williamsville, NY 14221-3178 | 716-836-4646 |
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