Provider Demographics
NPI:1447382106
Name:NEW HARTFORD SCANNER ASSOCIATES
Entity type:Organization
Organization Name:NEW HARTFORD SCANNER ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SPEACALIST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRIDORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-624-6254
Mailing Address - Street 1:1656 CHAMPLIN AVE
Mailing Address - Street 2:SUITE 229
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4830
Mailing Address - Country:US
Mailing Address - Phone:315-624-6254
Mailing Address - Fax:315-624-6281
Practice Address - Street 1:1656 CHAMPLIN AVE
Practice Address - Street 2:SUITE 229
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4830
Practice Address - Country:US
Practice Address - Phone:315-624-6254
Practice Address - Fax:315-624-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00780718Medicaid
NY363454OtherMVP
NY363454OtherMVP