Provider Demographics
NPI:1235566449
Name:PRO ULTRASOUND SERVICE
Entity Type:Organization
Organization Name:PRO ULTRASOUND SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:R
Authorized Official - Middle Name:
Authorized Official - Last Name:A
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-849-8331
Mailing Address - Street 1:39 DIVISION ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 DIVISION ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6714
Practice Address - Country:US
Practice Address - Phone:718-849-8331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile