Organization
LAKES RADIOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IDDO NETANYAHU MD (CEO)
(607) 324-8255
Entity
Organization
Contact information
Practice address
411 CANISTEO ST, RADIOLOGY, HORNELL, NY 14843-2104
(607) 324-8255
(607) 324-8774
Mailing address
7 ERIE AVE, RADIOLOGY, HORNELL, NY 14843-1909
(607) 324-8255
(607) 324-8774
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
167192
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000914685002
HEALTHNOW
NY
05
—
02412119
—
NY
01
—
G0187663370
BCBS OF CNY
NY
Enumeration date
05/11/2006
Last updated
02/04/2011
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