Provider Demographics
NPI:1578863049
Name:SCANWELL DIAGNOSTICS INC
Entity Type:Organization
Organization Name:SCANWELL DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-229-6000
Mailing Address - Street 1:1733 SHEEPSHEAD BAY RD
Mailing Address - Street 2:STE 29
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3728
Mailing Address - Country:US
Mailing Address - Phone:718-576-6991
Mailing Address - Fax:888-202-1021
Practice Address - Street 1:1733 SHEEPSHEAD BAY RD
Practice Address - Street 2:STE 29
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3728
Practice Address - Country:US
Practice Address - Phone:718-576-6991
Practice Address - Fax:888-202-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center