Eastern Portable X-Ray Corp

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

51019365 Issued in NY

Legal business name

EASTERN PORTABLE X-RAY CORP

Practice address

20 Peachtree CT Ste 103D
Holbrook, NY 11741-4616

Phone

(631) 563-7777

Fax

(631) 563-1078

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Steven Merced

Title

President

Phone

(631) 563-7777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Eastern Portable X-Ray Corp

  • Sonography Radiologic Technologist
  • Holbrook, NY
  • NPI 1730104720

  6305819178

  Same PAC ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerald Micalizzi, MD

  • Diagnostic Radiology Physician
  • Bridgeport, CT
  • NPI 1811982416
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1871524975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT STE 103D",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-563-7777",
            "fax_number": "631-563-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT STE 103D",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-563-7777",
            "fax_number": "631-563-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PORTABLE X-RAY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "MERCED",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-563-7777"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Radiography",
            "state": "NY",
            "license": "51019365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01901977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy A. Downing
• Danielle M Drucker
• James Anthony Duffy, LMHC-LP
• Kristin Durante
• Eastern Portable X-Ray Corp
• Mark Steven Eluto, PH.D.
• Empire Wellness Physician PC
• Empowering Minds Therapy Inc.
• Jessica P. Eng, O.D.
• Paul Gerard Espocia, P.T.

• Radiography Radiologic Technologist in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Radiography Radiologic Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.