# CT MOBILE DIAGNOSTIC SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073570206
- **Authorized official:** MR. MARK A GAMBARDELLA (PRESIDENT)
- **Authorized official phone:** (203) 467-6967

## Contact information

- **Practice address:** 249 W MAIN ST, C-3, BRANFORD, CT 06405-4048
- **Practice address phone:** (203) 488-1718
- **Practice address fax:** (203) 488-5016
- **Mailing address:** 249 W MAIN ST, C-3, BRANFORD, CT 06405-4048
- **Mailing address phone:** (203) 488-1718
- **Mailing address fax:** (203) 488-5016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2006
- **Last updated:** 08/22/2020