| Dr Susie Park, MD | |
| 43 New Scotland Ave, Dept Of Radiology Mc 113, Albany, NY 12208-3412 | |
| (518) 262-3722 | |
| Not Available | 
| Full Name | Dr Susie Park | 
|---|---|
| Gender | Female | 
| Speciality | Radiology - Pediatric Radiology | 
| Location | 43 New Scotland Ave, Albany, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1114177300 | NPI | - | NPPES | 
| 03649323 | Medicaid | NY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085P0229X | Radiology - Pediatric Radiology | 267437 (New York) | Primary | 
| Entity Name | Southern California Permanente Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 | 
| Entity Name | Los Alamitos Radiology Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1427005024 PECOS PAC ID: 5092718882 Enrollment ID: O20060816000607 | 
| Entity Name | Glendora Radiological Assoc Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1992797070 PECOS PAC ID: 2163514589 Enrollment ID: O20070815000331 | 
| Entity Name | Golden State Imaging Associates Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1144872052 PECOS PAC ID: 1254761315 Enrollment ID: O20200414001788 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Susie Park, MD 711 Troy Schenectady Rd, Suite 203, Latham, NY 12110-2442 Ph: (518) 782-3700 | Dr Susie Park, MD 43 New Scotland Ave, Dept Of Radiology Mc 113, Albany, NY 12208-3412 Ph: (518) 262-3722 | 
| Robert A Belgam, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 113 Holland Ave, Stratton Va Medical Center, Albany, NY 12208 Phone: 518-626-6650 Fax: 518-626-6644 | |
| Mr. Sreenivas Garla, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 47 New Scotland Ave, Radiology Dept, Albany, NY 12208 Phone: 518-262-3277 Fax: 518-262-4210 | |
| David Jahangir, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 315 S Manning Blvd, Albany, NY 12208 Phone: 518-525-1401 | |
| Dr. S Rao Aravapalli, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 47 New Scotland Ave, Dept. Of Radiology, Albany, NY 12208 Phone: 518-262-3277 Fax: 518-262-4210 | |
| Dr. Heidi Dambach, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 47 New Scotland Ave, Albany, NY 12208 Phone: 518-262-3277 | |
| Dr. Sheil Shah, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 315 S Manning Blvd, Albany, NY 12208 Phone: 518-525-1401 | |
| Justin John Hungerford, MD Radiology Medicare: Medicare Enrolled Practice Location: 47 New Scotland Ave, Albany, NY 12208 Phone: 518-262-3277 Fax: 518-262-4210 |