NPI | 1134790629 |
---|---|
Former Legal Business Name | ATLANTIC DIAGNOSTIC SERVICES LLC |
Entity Type | Organization |
Authorized Contact | LANELLE ANNE PICINICH Paralegal 973-451-2627 |
Organization Subpart ? | Yes |
Primary Taxonomy | 305R00000X Preferred Provider Organization |
Enumeration Date | 2021-07-06 |
Last Update Date | 2021-07-06 |