Provider Demographics
NPI:1245571678
Name:NOA DIAGNOSTICS OF NY LLC
Entity Type:Organization
Organization Name:NOA DIAGNOSTICS OF NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-986-2700
Mailing Address - Street 1:1186 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2322
Mailing Address - Country:US
Mailing Address - Phone:516-986-2700
Mailing Address - Fax:
Practice Address - Street 1:1186 BROADWAY
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2322
Practice Address - Country:US
Practice Address - Phone:516-986-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier