MEDICARE: MULTI MOBILE IMAGING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0208X	Mobile Radiology Clinic/Center
2	174400000X	Specialist

General Provider Information

NPI Number	:	1881640589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULTI MOBILE IMAGING, INC.

Provider Business Mailing Address
First Line	:	2678 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5947
Country	:	US
Telephone Number	:	718-333-0225
Fax Number	:	718-333-0224

Provider Business Practice Location Address
First Line	:	2678 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5947
Country	:	US
Telephone Number	:	718-333-0225
Fax Number	:	718-333-0224

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. STEVEN BUDKER
Credential	:
Telephone Number	:	718-333-0225

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	04/14/2010

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