Provider Demographics
NPI:1194117549
Name:LIBERTY MOBILE TESTING INC
Entity type:Organization
Organization Name:LIBERTY MOBILE TESTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAYORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKANDEROVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-404-4888
Mailing Address - Street 1:1513 ROYCE ST
Mailing Address - Street 2:APT 3K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5878
Mailing Address - Country:US
Mailing Address - Phone:718-872-5331
Mailing Address - Fax:718-872-5332
Practice Address - Street 1:2548 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5006
Practice Address - Country:US
Practice Address - Phone:718-872-5331
Practice Address - Fax:718-872-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty