Organization
NORTHERN CHAUTAUQUA RADIOLOGY LLC
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
189 E MAIN ST, WESTFIELD, NY 14787-1104
(716) 363-9342
Mailing address
PO BOX 110, FREDONIA, NY 14063-0110
(716) 363-6342
(716) 363-6345
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
Primary
185798
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026704301
UNIVERA
—
01
—
000511785004
BLUE CROSS
—
05
—
01246304
—
NY
Enumeration date
05/01/2007
Last updated
08/22/2020
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