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General NPI Number Information
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NPI Number | 1063516631
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Entity Type | Organization
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Legal Business Name | MD MOBILE LLC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 SCENIC DR SUITE 907
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City | HIGHLANDS
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State | NJ
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Zip | 07732-1329
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Country | US
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Telephone | 201-788-4962
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SCENIC DR SUITE 907
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City | HIGHLANDS
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State | NJ
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Zip | 07732-1329
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Country | US
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Telephone | 201-788-4962
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RALUCA COYLE
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Credential | MD
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Telephone | 201-585-5170
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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 | MA073751
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License Number State | NJ
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