| NPI | 1750964607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE GUHA Manager 347-304-9286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-07-01 |