Provider Demographics
NPI:1568016723
Name:MOBILE XRAY DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:MOBILE XRAY DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORTORELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-312-4050
Mailing Address - Street 1:14 MARLBOROUGH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2101
Mailing Address - Country:US
Mailing Address - Phone:617-312-4050
Mailing Address - Fax:
Practice Address - Street 1:141 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:WEST KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02892-1512
Practice Address - Country:US
Practice Address - Phone:401-515-7315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier