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General NPI Number Information
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NPI Number | 1043852338
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Entity Type | Organization
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Legal Business Name | LIFELINE IMAGING LLC
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/11/2020
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Provider Practice Location Address
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Address Line | 38 OPAL LN
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2827
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Country | US
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Telephone | 917-923-8484
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Fax | 888-510-9369
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Provider Business Mailing Address
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Address Line | PO BOX 90581
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City | STATEN ISLAND
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State | NY
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Zip | 10309-0581
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEANNA ZAMORE
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Credential |
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Telephone | 917-923-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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