1417678954 NPI number — RAPID RESPONSE PORTABLE X-RAY, LLC

Table of content: RAYMUND ANTONIO ESPINO GABRIEL (NPI 1437793502)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417678954 NPI number — RAPID RESPONSE PORTABLE X-RAY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAPID RESPONSE PORTABLE X-RAY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417678954
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21118 UNION TPKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND GARDENS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11364-3241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-217-8000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 MEADOWLARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-2235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-234-9904
Provider Business Practice Location Address Fax Number:
502-234-9908
Provider Enumeration Date:
09/02/2022

Additional Information

Authorized Official

Authorized Official Last Name:
LEDER
Authorized Official First Name:
MENACHEM
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
718-217-8000

Provider Taxonomy Codes

  • Taxonomy code: 335V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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