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General NPI Number Information
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NPI Number | 1699217539
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Entity Type | Organization
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Legal Business Name | SKY MOBILE DIGITAL IMAGING LLC
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 2 KENNEDY BLVD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1248
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Country | US
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Telephone | 732-839-9012
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Fax | 732-839-9012
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Provider Business Mailing Address
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Address Line | 194 DAFFODIL DR
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9355
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Country | US
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Telephone | 732-839-9010
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Fax | 732-839-9012
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER GUDAITIS
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Credential |
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Telephone | 732-245-5123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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