Provider Demographics
NPI:1932501327
Name:EAST COAST DIAGNOSTICS INC
Entity Type:Organization
Organization Name:EAST COAST DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAGANOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-862-0406
Mailing Address - Street 1:1230 AVENUE Y APT A8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4271
Mailing Address - Country:US
Mailing Address - Phone:917-862-0406
Mailing Address - Fax:917-831-4301
Practice Address - Street 1:2026 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7396
Practice Address - Country:US
Practice Address - Phone:917-297-6500
Practice Address - Fax:917-831-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty