1841375094 NPI number — PRECIPIO INC

Table of content: (NPI 1841375094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841375094 NPI number — PRECIPIO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRECIPIO INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841375094
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 SCIENCE PARK STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06511-1962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-787-7888
Provider Business Mailing Address Fax Number:
203-901-1289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 SCIENCE PARK STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06511-1962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-787-7888
Provider Business Practice Location Address Fax Number:
203-901-1289
Provider Enumeration Date:
10/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ILJAZI
Authorized Official First Name:
MEHMED
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
203-787-7888

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30057 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 117236600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".