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General NPI Number Information
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NPI Number | 1033505532
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Entity Type | Organization
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Legal Business Name | GALAXY MOBILE DIAGNOSTICS SERVICES LLC
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 2 KENNEDY BLVD 2ND FLOOR
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1248
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Country | US
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Telephone | 201-426-0220
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Fax | 732-839-9012
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Provider Business Mailing Address
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Address Line | 2 KENNEDY BLVD 2ND FLOOR
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1248
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Country | US
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Telephone | 201-426-0220
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Fax | 732-839-9012
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PETER GUDAITIS
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Credential |
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Telephone | 718-789-1818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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