Provider Demographics
NPI:1215105739
Name:ORANGE COUNTY RADIATION ONCOLOGY
Entity type:Organization
Organization Name:ORANGE COUNTY RADIATION ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:UMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-534-4700
Mailing Address - Street 1:2565 US HIGHWAY 9W
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1309
Mailing Address - Country:US
Mailing Address - Phone:845-534-4700
Mailing Address - Fax:845-534-4800
Practice Address - Street 1:2565 US HIGHWAY 9W
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1309
Practice Address - Country:US
Practice Address - Phone:845-534-4700
Practice Address - Fax:845-534-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135691261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00960843Medicaid
NYW6T901Medicare PIN
NY00960843Medicaid