Organization
COMMUNITY CARE PHYSICIANS, PC
Active
Other names
ImageCare Park South
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M STAMAS (SENIOR CREDENTIALING COORDINATOR)
(518) 782-3742
Entity
Organization
Contact information
Practice address
391 MYRTLE AVE, SUITE 4D, ALBANY, NY 12208-3513
(518) 207-2280
(518) 207-2281
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
248413
NY
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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