Provider Demographics
NPI:1477906022
Name:ATLAS DIAGNOSTIC HOLDINGS, LLC
Entity Type:Organization
Organization Name:ATLAS DIAGNOSTIC HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHESKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-468-7480
Mailing Address - Street 1:1160 60TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4924
Mailing Address - Country:US
Mailing Address - Phone:718-789-1818
Mailing Address - Fax:718-789-1616
Practice Address - Street 1:10150 HIGHLAND MANOR DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9713
Practice Address - Country:US
Practice Address - Phone:718-789-1818
Practice Address - Fax:718-789-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
E1799AMedicare PIN