Organization
EASTERN PORTABLE X-RAY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN MERCED (PRESIDENT)
(631) 563-7777
Entity
Organization
Contact information
Practice address
20 PEACHTREE CT STE 103D, HOLBROOK, NY 11741-4616
(631) 563-7777
(631) 563-1078
Mailing address
20 PEACHTREE CT STE 103D, HOLBROOK, NY 11741-4616
(631) 563-7777
(631) 563-1078
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
51019365
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01901977
—
NY
Enumeration date
07/06/2006
Last updated
04/24/2024
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