Organization
PORTABLE IMAGING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAVIAN O DONALDSON RT(R) (RADIOLOGY TECHNOLOGIST/MANAGER)
19177219418
Entity
Organization
Contact information
Practice address
2770 YATES AVE, BRONX, NY 10469-5331
(917) 721-9418
Mailing address
2770 YATES AVE, BRONX, NY 10469-5331
(917) 721-9418
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
051655
NY
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
051655
NY
Other
Enumeration date
04/24/2008
Last updated
04/25/2008
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