Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Medical Imaging LLC

Organization Diagnostic Radiology Physician · NPI 1861763005

Great Lakes Medical Imaging LLC provides Diagnostic Radiology Physician services in Williamsville, New York. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3178
Phone: (716) 836-4646
Fax: (716) 836-4696
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X

Record details

NPI number1861763005
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenneth Pearsen — Md · (716) 836-4646
NPI enumeratedJanuary 19, 2012
Last updated in NPPESAugust 21, 2023
Certification dateAugust 21, 2023
Mailing address111 N Maplemere Rd Ste 120, Williamsville, NY 14221-3178

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