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General NPI Number Information
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NPI Number | 1194117549
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Entity Type | Organization
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Legal Business Name | LIBERTY MOBILE TESTING INC
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 2548 CONEY ISLAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11223-5006
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Country | US
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Telephone | 718-872-5331
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Fax | 718-872-5332
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Provider Business Mailing Address
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Address Line | 1513 ROYCE ST APT 3K
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City | BROOKLYN
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State | NY
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Zip | 11234-5878
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Country | US
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Telephone | 718-872-5331
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Fax | 718-872-5332
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Authorized Official
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Title or Position | DIRECTOR
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Name | SAYORA ISKANDEROVA
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Credential |
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Telephone | 718-404-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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