Organization
NORTHERN TIER IMAGING CORP
Active
Organization
NORTHERN TIER IMAGING CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL SHADEROWFSKY MD (PRESIDENT/RADIOLOGIST)
(570) 281-1315
Entity
Organization
Contact information
Practice address
638 FAIRVIEW ROAD, CLARKS SUMMIT, PA 18411-8955
(570) 281-1287
(570) 281-1256
Mailing address
PO BOX 517, CARBONDALE, PA 18407-0517
(570) 281-1287
(570) 281-1256
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD070287L
PA
2085U0001X
Diagnostic Ultrasound Physician
MD070287L
PA
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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