Organization
MAIN STREET DIAGNOSTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINEL DAVIDOV (PRESIDENT)
(646) 210-1000
Entity
Organization
Contact information
Practice address
6854 MAIN ST, FLUSHING, NY 11367-1325
(646) 210-1000
Mailing address
6854 MAIN ST, FLUSHING, NY 11367-1325
(646) 210-1000
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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