Provider Demographics
NPI:1447262738
Name:SPECIALTY TELERADIOLOGY, INC.
Entity type:Organization
Organization Name:SPECIALTY TELERADIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAZIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-373-1043
Mailing Address - Street 1:1648 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2443
Mailing Address - Country:US
Mailing Address - Phone:216-373-1043
Mailing Address - Fax:
Practice Address - Street 1:18777 LOOKOUT CIR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-1713
Practice Address - Country:US
Practice Address - Phone:216-373-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty