Healthcare Provider Details

I. General information

NPI: 1770676686
Provider Name (Legal Business Name): NEW ENGLAND MOBILE X-RAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERRILL INDUSTRIAL DR SUITE 19
HAMPTON NH
03842-1981
US

IV. Provider business mailing address

1 MERRILL INDUSTRIAL DR SUITE 19
HAMPTON NH
03842-1981
US

V. Phone/Fax

Practice location:
  • Phone: 617-341-9729
  • Fax:
Mailing address:
  • Phone: 617-341-9729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALLEN E SMITH
Title or Position: CFO
Credential:
Phone: 617-341-9729