1669515391 NPI number — ACCURATE DIAGNOSTICS LABS, INC.

Table of content: (NPI 1669515391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669515391 NPI number — ACCURATE DIAGNOSTICS LABS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCURATE DIAGNOSTICS LABS, 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:
1669515391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 HADLEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH PLAINFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07080-1183
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-839-3300
Provider Business Mailing Address Fax Number:
732-839-3303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 HADLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH PLAINFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07080-1183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-839-3300
Provider Business Practice Location Address Fax Number:
732-839-3303
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
RUPEN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-839-3300

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  00007514 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 96806 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0493449 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8428107 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 043079 . This is a "PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00152416 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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