Provider Demographics
NPI:1386174779
Name:PAMIR MOBILE DIAGNOSTIC SERVICES INC.
Entity type:Organization
Organization Name:PAMIR MOBILE DIAGNOSTIC SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOHALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:QURBANZADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-768-2467
Mailing Address - Street 1:199 DENVER RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3205
Mailing Address - Country:US
Mailing Address - Phone:347-168-2467
Mailing Address - Fax:
Practice Address - Street 1:14715 35TH AVE APT 2C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3704
Practice Address - Country:US
Practice Address - Phone:347-768-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5121274OtherDOS ID#