Organization
EZ DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE LYDIA BLAINE CRT (OWNER/PRESIDENT)
(919) 780-5900
Entity
Organization
Contact information
Practice address
343 TECHNOLOGY DR, SUITE 1110, GARNER, NC 27529-7949
(919) 780-5900
(919) 780-5905
Mailing address
343 TECHNOLOGY DR, SUITE 1110, GARNER, NC 27529-7949
(919) 780-5900
(919) 780-5905
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
34166
NC
207R00000X
Internal Medicine Physician
34166
NC
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
2084N0400X
Neurology Physician
037102
NC
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
NC
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
4125
NC
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
A 2559
NC
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
A 2855
NC
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
A 4248
NC
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
A 725
NC
2279P1004X
Pulmonary Diagnostics Registered Respiratory Therapist
A-5047
NC
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
01/21/2011
Last updated
09/15/2011
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