Provider Demographics
NPI:1548621147
Name:NEWTECH DIAGNOSTICS
Entity type:Organization
Organization Name:NEWTECH DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEECEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:551-579-6651
Mailing Address - Street 1:3000 JOHN F KENNEDY BLVD
Mailing Address - Street 2:# 310
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3817
Mailing Address - Country:US
Mailing Address - Phone:551-579-6651
Mailing Address - Fax:551-222-4483
Practice Address - Street 1:3000 JOHN F KENNEDY BLVD
Practice Address - Street 2:# 310
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3817
Practice Address - Country:US
Practice Address - Phone:551-579-6651
Practice Address - Fax:551-222-4483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier