Provider Demographics
NPI:1295515419
Name:NY FIVE BOROUGHS MOBILE ULTRASOUND
Entity type:Organization
Organization Name:NY FIVE BOROUGHS MOBILE ULTRASOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ULTRASOUND TECH/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OB/GYN, RVT, ARDMS
Authorized Official - Phone:347-581-8716
Mailing Address - Street 1:358 HENDRIX ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-3609
Mailing Address - Country:US
Mailing Address - Phone:347-581-8716
Mailing Address - Fax:
Practice Address - Street 1:4131 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-5633
Practice Address - Country:US
Practice Address - Phone:347-581-8716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier