Organization
MOBILE DIAGNOSTIC TESTING SERVICES INC
Active
Other names
HealthTrac
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL T MCDONNELL (EXECUTIVE VICE PRESIDENT)
(716) 686-7110
Entity
Organization
Contact information
Practice address
4950 GENESEE ST, SUITE 180, BUFFALO, NY 14225-5550
(716) 686-7100
(716) 614-3282
Mailing address
4950 GENESEE ST, SUITE 180, BUFFALO, NY 14225-5550
(716) 686-7100
(716) 614-3282
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020000502
UNIVERA
NY
01
—
000510159003
BC BS WNY
NY
01
—
0073926
GOVT INS
NY
01
—
7602181
IHA
NY
Enumeration date
02/26/2007
Last updated
06/25/2012
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