Provider Demographics
NPI:1699325472
Name:COOS NORTH COUNTRY RADIOLOGY P.L.L.C.
Entity type:Organization
Organization Name:COOS NORTH COUNTRY RADIOLOGY P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKSHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:PALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-575-9046
Mailing Address - Street 1:1 HARDY RD # 1204
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4915
Mailing Address - Country:US
Mailing Address - Phone:603-575-9046
Mailing Address - Fax:
Practice Address - Street 1:59 PAGE HILL RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-3531
Practice Address - Country:US
Practice Address - Phone:603-788-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty