| NPI | 1962921445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAISON JOSEPH Owner 914-439-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OK 37D2057496) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2020-11-13 |