Healthcare Provider Details

I. General information

NPI: 1477177962
Provider Name (Legal Business Name): SINAI PORTABLE X-RAY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63187 ALDERTON ST BSMT
REGO PARK NY
11374-3919
US

IV. Provider business mailing address

63187 ALDERTON ST
REGO PARK NY
11374-3919
US

V. Phone/Fax

Practice location:
  • Phone: 347-935-3011
  • Fax: 347-935-3038
Mailing address:
  • Phone: 347-935-3011
  • Fax: 347-935-3038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MOSHE SAMEKHOV
Title or Position: CEO/SERVICE DIRECTOR
Credential: ARRT
Phone: 347-935-3011