Provider Demographics
NPI:1508677519
Name:LIFE MOBILE IMAGING, INC
Entity type:Organization
Organization Name:LIFE MOBILE IMAGING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-644-2661
Mailing Address - Street 1:70 S ORANGE AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4915
Mailing Address - Country:US
Mailing Address - Phone:551-225-0800
Mailing Address - Fax:
Practice Address - Street 1:70 S ORANGE AVE STE 235
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4915
Practice Address - Country:US
Practice Address - Phone:973-607-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier