Healthcare Provider Details

I. General information

NPI: 1477670883
Provider Name (Legal Business Name): ULTRAMOBILE IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 JEFFERSON RD
ROCHESTER NY
14623-3149
US

IV. Provider business mailing address

1465 JEFFERSON RD
ROCHESTER NY
14623-3149
US

V. Phone/Fax

Practice location:
  • Phone: 585-424-6270
  • Fax: 585-424-6274
Mailing address:
  • Phone: 585-424-6270
  • Fax: 585-424-6274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number27021011
License Number StateNY

VIII. Authorized Official

Name: MR. WILLIAM IRWIN
Title or Position: OWNER
Credential:
Phone: 585-424-6270