Organization
SPECIALTY PORTABLE X-RAY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA FOWLER (OWNER)
(516) 432-3800
Entity
Organization
Contact information
Practice address
99 JERICHO TURNPIKE, JERICHO, NY 11753-1015
(516) 432-3800
(516) 897-3915
Mailing address
99 JERICHO TURNPIKE, JERICHO, NY 11753-1015
(516) 432-3800
(516) 897-3915
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
29021253
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02849241
—
NY
01
—
02865
BCBS
NY
01
—
O98881
BCBS
NY
Enumeration date
11/02/2006
Last updated
03/01/2012
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