| NPI | 1780042937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE TKEBUCHAVA President 917-562-7003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-02-03 |