Mobile Diagnostic Services Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MOBILE DIAGNOSTIC SERVICES INC

Practice address

40 Galesi Dr
Wayne, NJ 07470-4826

Phone

(973) 812-1300

Fax

(973) 812-0992

NPI assigned

Mar 15, 2006

Last updated

Jan 9, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew S Goldreich

Title

VP

Phone

(973) 812-1300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1669441416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 N BEVERWYCK RD",
            "address_2": "BOX 334",
            "city": "LAKE HIAWATHA",
            "state": "NJ",
            "postal_code": "070341909",
            "telephone_number": "973-812-1300",
            "fax_number": "973-812-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GALESI DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704826",
            "telephone_number": "973-812-1300",
            "fax_number": "973-812-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DIAGNOSTIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "GOLDREICH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "973-812-1300"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Minichiello, LCSW
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• Ken Edward Mishler, MD
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• Devas J. Modi, DO
• Nina Mohammed, MD

• Physiological Laboratory in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Physiological Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.