Provider Demographics
NPI:1457964702
Name:TIME LINE DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:TIME LINE DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED CARDIAC SONOGRAPHE
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RCS
Authorized Official - Phone:732-318-2341
Mailing Address - Street 1:25 CINDER ROAD APT 3J
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-318-2341
Mailing Address - Fax:
Practice Address - Street 1:25 CINDER ROAD APT 3J
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-318-2341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TIME LINE DIAGNOSTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty