Provider Demographics
NPI:1962925388
Name:MDX SOLUTIONS GROUP INC
Entity type:Organization
Organization Name:MDX SOLUTIONS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:METCALF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-698-3032
Mailing Address - Street 1:272 DARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2650
Mailing Address - Country:US
Mailing Address - Phone:718-698-3032
Mailing Address - Fax:718-761-3162
Practice Address - Street 1:4131 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-5633
Practice Address - Country:US
Practice Address - Phone:718-698-3032
Practice Address - Fax:718-761-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherCOMMERCIAL