Provider Demographics
NPI:1760266357
Name:NOVA DIAGNOSTIC SERVICES LLC
Entity Type:Organization
Organization Name:NOVA DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EFRAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELCHONEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-744-4705
Mailing Address - Street 1:12 FRANKLIN PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1294
Mailing Address - Country:US
Mailing Address - Phone:516-862-4900
Mailing Address - Fax:516-862-4902
Practice Address - Street 1:12 FRANKLIN PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1294
Practice Address - Country:US
Practice Address - Phone:516-862-4900
Practice Address - Fax:516-862-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
No246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Multi-Specialty