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General NPI Number Information
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NPI Number | 1881141364
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Entity Type | Organization
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Legal Business Name | MAS IMAGING PORTABLE X-RAY INC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 90 ARRIVAL AVE STE 105
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City | RONKONKOMA
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State | NY
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Zip | 11779
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Country | US
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Telephone | 631-912-7476
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Fax |
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Provider Business Mailing Address
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Address Line | 90 ARRIVAL AVE STE 105
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City | RONKONKOMA
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State | NY
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Zip | 11779-7361
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Country | US
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Telephone | 631-912-7476
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MARLO SUAZO
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Credential |
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Telephone | 631-912-7476
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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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