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General NPI Number Information
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NPI Number | 1720114721
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Entity Type | Organization
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Legal Business Name | MOBILE DIAGNOSTIC TST SERV INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 3050 WHITESTONE EXPY SUITE 205
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City | FLUSHING
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State | NY
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Zip | 11354-1995
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Country | US
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Telephone | 800-626-1616
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Fax | 718-358-1082
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Provider Business Mailing Address
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Address Line | 4950 GENESEE ST SUITE 180
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City | BUFFALO
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State | NY
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Zip | 14225-5550
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Country | US
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Telephone | 716-686-7100
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Fax | 716-614-3282
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN ROBINSON
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Credential |
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Telephone | 614-614-3285
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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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