Organization
EAST SHORE DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMAZ MITAISHVILI (PRESIDENT)
(818) 731-9716
Entity
Organization
Contact information
Practice address
7506 16TH AVE, STE2, BROOKLYN, NY 11214-1064
(818) 731-9716
Mailing address
7506 16TH AVE, STE2, BROOKLYN, NY 11214-1064
(818) 731-9716
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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