Healthcare Provider Details

I. General information

NPI: 1790103778
Provider Name (Legal Business Name): MULTI MOBILE IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SPRINGFIELD AVE SUITE 302B
SUMMIT NJ
07901-4608
US

IV. Provider business mailing address

360 SPRINGFIELD AVE SUITE 302B
SUMMIT NJ
07901-4608
US

V. Phone/Fax

Practice location:
  • Phone: 973-969-6000
  • Fax: 609-949-5555
Mailing address:
  • Phone: 973-969-6000
  • Fax: 609-949-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEX SHAPIRO
Title or Position: PRESIDENT
Credential:
Phone: 973-969-6000