Organization
CARNEY RADIOLOGY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD I HERMAN MD (PRESIDENT)
(617) 296-4000
Entity
Organization
Contact information
Practice address
2100 DORCHESTER AVE, BOSTON, MA 02124-5615
(617) 296-4000
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-5363
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
MA
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9714618
—
MA
01
—
CK1340
RR MEDICARE
MA
01
—
M12723
BLUE SHIELD
MA
Enumeration date
02/22/2007
Last updated
05/29/2012
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