| NPI | 1093274680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JACOBSON Owner 914-345-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2021-06-02 |