Provider Demographics
NPI:1578920161
Name:NEW YORK HOME XRAY,LLC
Entity Type:Organization
Organization Name:NEW YORK HOME XRAY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:RTRL
Authorized Official - Phone:845-590-3331
Mailing Address - Street 1:3 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1017
Mailing Address - Country:US
Mailing Address - Phone:845-590-3331
Mailing Address - Fax:845-855-1010
Practice Address - Street 1:2601 BELMAR BLVD
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-4167
Practice Address - Country:US
Practice Address - Phone:845-590-3331
Practice Address - Fax:845-855-1010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK HOME XRAY,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier