Provider Demographics
NPI:1689791717
Name:STAT PORTABLE X-RAY,INC.
Entity Type:Organization
Organization Name:STAT PORTABLE X-RAY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL MANAGER OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATSCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-217-8000
Mailing Address - Street 1:21118 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3241
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:718-217-5485
Practice Address - Street 1:21118 UNION TPKE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3241
Practice Address - Country:US
Practice Address - Phone:718-217-8000
Practice Address - Fax:718-217-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYH98 1204506 76247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01867523Medicaid
NY01732801Medicaid
NY01867523Medicaid
NY01732801Medicaid