Provider Demographics
NPI:1740513662
Name:GALAXY MOBILE DIAGNOSTICS SERVICES LLC
Entity type:Organization
Organization Name:GALAXY MOBILE DIAGNOSTICS SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHESKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-789-1818
Mailing Address - Street 1:1160 60TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4924
Mailing Address - Country:US
Mailing Address - Phone:718-789-1818
Mailing Address - Fax:718-789-1616
Practice Address - Street 1:14 COMMERCE DR STE 306
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3514
Practice Address - Country:US
Practice Address - Phone:201-426-0220
Practice Address - Fax:732-839-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335V00000X
NJ335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0427055Medicaid
NJ225190Medicare PIN