ST. JOSEPH'S IMAGING NPI 1457361529

NPI Information

NPI: 1457361529
Provider Name: ST. JOSEPH'S IMAGING
Classification: Nurse Practitioner - 363LA2200X
Specialization: Adult Health
Entity Type: Organization
Address: 4109 MEDICAL CENTER DR
FAYETTEVILLE, NY
ZIP 13066
Phone: (315) 329-7555

Map and Directions

Get Directions

NPI Details

ST. JOSEPH'S IMAGING is an adult health nurse practitioner in Fayetteville, NY. ST. JOSEPH'S IMAGING NPI is 1457361529. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4109 MEDICAL CENTER DR
FAYETTEVILLE, NY
ZIP 13066-600
Phone: (315) 329-7555
Fax: (315) 329-7559

The provider's authorized official is Ann M Roman .
The authorized official title is Interventional Radiology and has the following contact phone number (315) 329-7555.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 10/3/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	302135	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BB8287	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
2	S95084	MEDICARE UPIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI