Provider Demographics
NPI:1184894024
Name:SONOSCAN LLC
Entity type:Organization
Organization Name:SONOSCAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREISDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TKESHELASHVILI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-710-7017
Mailing Address - Street 1:12F QUEEN ANNE WAY
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2538
Mailing Address - Country:US
Mailing Address - Phone:443-870-3750
Mailing Address - Fax:
Practice Address - Street 1:12F QUEEN ANNE WAY
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2538
Practice Address - Country:US
Practice Address - Phone:443-870-3750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
No2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional TechnologyGroup - Multi-Specialty
No2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Multi-Specialty
No2471V0106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular-Interventional TechnologyGroup - Multi-Specialty