Provider Demographics
NPI:1902228364
Name:EZ TESTING MEDICAL DIAGNOSTIC PC
Entity Type:Organization
Organization Name:EZ TESTING MEDICAL DIAGNOSTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-462-9925
Mailing Address - Street 1:2264 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4058
Mailing Address - Country:US
Mailing Address - Phone:347-462-9925
Mailing Address - Fax:347-462-9158
Practice Address - Street 1:2264 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4058
Practice Address - Country:US
Practice Address - Phone:347-462-9925
Practice Address - Fax:347-462-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty