Provider Demographics
NPI:1073742201
Name:MDS DIGITAL XRAY SERVICES INC
Entity Type:Organization
Organization Name:MDS DIGITAL XRAY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUNEEER
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-626-0800
Mailing Address - Street 1:862 NEWARK AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5162
Mailing Address - Country:US
Mailing Address - Phone:201-798-9000
Mailing Address - Fax:201-798-9401
Practice Address - Street 1:862 NEWARK AVE
Practice Address - Street 2:STE 103
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5162
Practice Address - Country:US
Practice Address - Phone:201-798-9000
Practice Address - Fax:201-798-9401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MDS DIGITAL XRAY SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory