Provider Demographics
NPI:1952637662
Name:MOBILE DIAGNOSTIC TESTING INC
Entity Type:Organization
Organization Name:MOBILE DIAGNOSTIC TESTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-6300
Mailing Address - Street 1:1389 E 18TH ST
Mailing Address - Street 2:SUITEG1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7521
Mailing Address - Country:US
Mailing Address - Phone:718-338-6300
Mailing Address - Fax:347-710-1969
Practice Address - Street 1:1389 E 18TH ST
Practice Address - Street 2:SUITEG1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7521
Practice Address - Country:US
Practice Address - Phone:718-338-6300
Practice Address - Fax:347-710-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center