Healthcare Provider Details

I. General information

NPI: 1861373078
Provider Name (Legal Business Name): EXPERT MOBILE IMAGING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 POPLAR AVE
MOUNTAINSIDE NJ
07092-1928
US

IV. Provider business mailing address

2609 E 14TH ST
BROOKLYN NY
11235-3915
US

V. Phone/Fax

Practice location:
  • Phone: 901-284-3772
  • Fax:
Mailing address:
  • Phone: 901-284-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. DENNIS SHAKHNOVICH
Title or Position: FOUNDER
Credential:
Phone: 901-284-3772