Organization
MOHAWK GLEN IMAGING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE BURGREEN M.D. (DEPARTMENT HEAD)
(315) 334-9729
Entity
Organization
Contact information
Practice address
91 PERIMETER RD, ROME, NY 13441-4018
(315) 334-9729
Mailing address
PO BOX 669, ROME, NY 13442-0669
(315) 339-7965
(315) 709-0288
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
153927
NY
Other
Enumeration date
08/22/2005
Last updated
12/14/2009
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