Provider Demographics
NPI:1194761692
Name:NORTHAMPTON RADIOLOGIC ASSOCIATES, INC.
Entity type:Organization
Organization Name:NORTHAMPTON RADIOLOGIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:POLINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-695-8367
Mailing Address - Street 1:291 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1246
Mailing Address - Country:US
Mailing Address - Phone:800-688-6666
Mailing Address - Fax:413-589-7554
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2101
Practice Address - Fax:413-582-2949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA701726OtherTUFTS
MA9721185Medicaid
MA0012697OtherAETNA
MA0008277OtherNEIGHBORHOOD HEALTH PLAN
VT1006064OtherMEDICAID
MA686823OtherCONNECTICARE
MA101822800OtherUS DEPT. OF LABOR
MACM0600OtherRAILRAOD MEDICARE