Provider Demographics
NPI:1588775654
Name:CANAL RADIOLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:CANAL RADIOLOGY ASSOCIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PICCINNINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-349-5799
Mailing Address - Street 1:44000 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1125
Mailing Address - Country:US
Mailing Address - Phone:586-412-4379
Mailing Address - Fax:586-412-4101
Practice Address - Street 1:212 CANAL STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4156
Practice Address - Country:US
Practice Address - Phone:212-349-5799
Practice Address - Fax:212-349-2760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01496015Medicaid
NYW6L041Medicare UPIN