| NPI | 1245539741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN WILDES Office Manager 718-438-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NY 119277) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2011-03-23 |