Provider Demographics
NPI:1508119660
Name:SIGL LLC
Entity Type:Organization
Organization Name:SIGL LLC
Other - Org Name:HEART SCAN BUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:EUNSUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-478-3040
Mailing Address - Street 1:11-06 FAIR LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2228
Mailing Address - Country:US
Mailing Address - Phone:201-978-9199
Mailing Address - Fax:
Practice Address - Street 1:11-06 FAIR LAWN AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2228
Practice Address - Country:US
Practice Address - Phone:201-978-9199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier