Provider Demographics
NPI:1346670973
Name:ADVANCED DIAGNOSTIC SERVICES INC
Entity Type:Organization
Organization Name:ADVANCED DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAIKH
Authorized Official - Middle Name:H
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-445-4254
Mailing Address - Street 1:99 METROPOLITAN OVAL.
Mailing Address - Street 2:SUITE # 6E
Mailing Address - City:BRONX.
Mailing Address - State:NY
Mailing Address - Zip Code:10462
Mailing Address - Country:US
Mailing Address - Phone:347-445-4254
Mailing Address - Fax:
Practice Address - Street 1:1268 WHITE PLAINS ROAD.
Practice Address - Street 2:R # 6 (GROUND LEVEL SHAIKH)
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472
Practice Address - Country:US
Practice Address - Phone:347-445-4254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory