Organization
PARK AVENUE ASSOCIATES IN RADIOLOGY PC
Active
Other names
Southern Tier Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD SANTELLI (PRESIDENT)
(607) 729-2125
Entity
Organization
Contact information
Practice address
32-36 HARRISON ST, JOHNSON CITY, NY 13790-2122
(607) 763-6104
Mailing address
PO BOX 23, CANAJOHARIE, NY 13317-0023
(315) 362-5285
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00553397
—
NY
Enumeration date
04/20/2006
Last updated
03/09/2020
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