Provider Demographics
NPI:1952608325
Name:ON-SITE ULTRASOUND LLC
Entity Type:Organization
Organization Name:ON-SITE ULTRASOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:OLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZIUBA
Authorized Official - Suffix:
Authorized Official - Credentials:BBA
Authorized Official - Phone:505-573-2495
Mailing Address - Street 1:1804 JUNE ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-3146
Mailing Address - Country:US
Mailing Address - Phone:505-843-9836
Mailing Address - Fax:866-688-1632
Practice Address - Street 1:1804 JUNE ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-3146
Practice Address - Country:US
Practice Address - Phone:505-843-9836
Practice Address - Fax:866-688-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, MobileGroup - Single Specialty