Provider Demographics
NPI:1568535920
Name:MULTISCAN PORTABLE IMAGING,INC.
Entity Type:Organization
Organization Name:MULTISCAN PORTABLE IMAGING,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SULINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS,RDMS,RVT
Authorized Official - Phone:631-361-8770
Mailing Address - Street 1:21 HOLIDAY PARK DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2110
Mailing Address - Country:US
Mailing Address - Phone:631-361-8770
Mailing Address - Fax:631-361-8771
Practice Address - Street 1:21 HOLIDAY PARK DR
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2110
Practice Address - Country:US
Practice Address - Phone:631-361-8770
Practice Address - Fax:631-361-8771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z411Medicare ID - Type Unspecified
NY03518Medicare ID - Type Unspecified