Healthcare Provider Details

I. General information

NPI: 1861724205
Provider Name (Legal Business Name): S GROUP EXPRESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 AVENUE U
BROOKLYN NY
11223-4135
US

IV. Provider business mailing address

PO BOX 240430
BROOKLYN NY
11224-0430
US

V. Phone/Fax

Practice location:
  • Phone: 347-492-7809
  • Fax: 347-492-7810
Mailing address:
  • Phone: 347-492-7809
  • Fax: 347-492-7810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MILENA BARSKAYA
Title or Position: REGISTERED VASCULAR TECHNOLOGIST
Credential:
Phone: 347-492-7809