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General NPI Number Information
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NPI Number | 1063111938
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Entity Type | Organization
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Legal Business Name | SOHO DIAGNOSTICS INK CORPORATION
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 154 E BOSTON POST RD
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City | MAMARONECK
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State | NY
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Zip | 10543-3736
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Country | US
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Telephone | 917-224-1677
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Fax | 718-216-0019
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Provider Business Mailing Address
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Address Line | PO BOX 194
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City | MAMARONECK
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State | NY
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Zip | 10543-0194
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Country | US
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Telephone | 855-682-2455
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Fax | 855-835-5857
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Authorized Official
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Title or Position | OWNER
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Name | JAMES THOMAS BECKER
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Credential |
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Telephone | 855-682-2455
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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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