# MAS IMAGING PORTABLE X-RAY INC

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

## Provider details

- **NPI number:** 1144876483
- **Authorized official:** MARLO SUAZO (OWNER)
- **Authorized official phone:** (631) 551-5101

## Contact information

- **Practice address:** 90 ARRIVAL AVE STE 105, RONKONKOMA, NY 11779-7361
- **Practice address phone:** (631) 551-5101
- **Mailing address:** 90 ARRIVAL AVE STE 105, RONKONKOMA, NY 11779-7361

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 08/13/2019
- **Last updated:** 10/10/2019