=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205081619
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | US DIAGNOSTICS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/26/2008
-----------------------------------------------------
Last Update Date | 11/26/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 BRIDGE ST
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08848-1223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-505-1100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 KELSEY FARM RD
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08848-2126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-505-1100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. EDWARD JAMES LETKO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-402-5900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0100981097
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------