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1689447302 NPI number — PROSCAN MOBILE ULTRASOUND LLC

NPI Number: 1689447302
Health Care Provider/Practitioner: PROSCAN MOBILE ULTRASOUND LLC

Information about “1689447302” NPI (PROSCAN MOBILE ULTRASOUND LLC) exists in 1689447302 in HTML format HTML  |  1689447302 in plain Text format TXT  |  1689447302 in PDF (Portable Document Format) PDF  |  1689447302 in an XML format XML  formats.

NPI Number : 1689447302 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689447302",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PROSCAN MOBILE ULTRASOUND LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "858 COUNTY ROUTE 38",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORFOLK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "13667-3205",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "315-267-6159",
    "MailingAddressFaxNumber": "315-262-8117",
    "FirstLinePracticeLocationAddress": "858 COUNTY ROUTE 38",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORFOLK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "13667-3205",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "315-267-6159",
    "PracticeLocationAddressFaxNumber": "315-262-8117",
    "EnumerationDate": "11/03/2023",
    "LastUpdateDate": "11/03/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BERTRAND",
    "AuthorizedOfficialFirstName": "BRANDON",
    "AuthorizedOfficialMiddleName": "MICHAEL",
    "AuthorizedOfficialTitle": "CEO/ ULTRASOUND TECHNOLOGIST",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RDMS(OB/GYN)",
    "AuthorizedOfficialTelephoneNumber": "315-614-2858",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2085U0001X",
        "TaxonomyName": "Diagnostic Ultrasound Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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