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Organization
CHAUTAUQUA RADIOLOGY, PC
Active
Organization
CHAUTAUQUA RADIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON A MUNTZ MD (PRESIDENT)
(716) 363-6342
Entity
Organization
Contact information
Practice address
529 CENTRAL AVE, DUNKIRK, NY 14048-2514
(716) 672-8040
(716) 672-8060
Mailing address
PO BOX 69, FREDONIA, NY 14063-0069
(716) 672-8040
(716) 672-8060
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
Primary
185798
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026704302
UNIVERA
—
01
—
000511785003
BLUE CROSS
—
05
—
01246304
—
NY
05
—
01943026
—
NY
01
—
5609140
INDEPENDENT HEALTH
—
01
—
CM1926
RR MEDICARE
—
Enumeration date
04/25/2007
Last updated
08/27/2009
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