| Ima | |
|
961 Canal St Syracuse NY 13210-1203 | |
| (315) 478-1977 | |
| (315) 428-9233 |
| Full Name | Ima |
|---|---|
| Speciality | Internal Medicine |
| Location | 961 Canal St, Syracuse, New York |
| Authorized Official Name and Position | John C Radford (OWNER) |
| Authorized Official Contact | 7166999032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ima Po Box 248 Ellicottville NY 14731-0248 Ph: (315) 478-1977 | Ima 961 Canal St Syracuse NY 13210-1203 Ph: (315) 478-1977 |
| NPI Number | 1225402779 |
|---|---|
| Provider Enumeration Date | 11/20/2015 |
| Last Update Date | 11/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225402779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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