Organization Name: | 675 DELAWARE LLC |
NPI Number: | 1346570827 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD CROSS (MANAGING PARTNER) |
Mailing Address: | 6364 White Oak Way Lake View |
State: | NY US |
Postal Code: | 140859572 |
Phone Number: | 7169979410 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2010 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 293D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Laboratories |
Taxonomy Classification: | Physiological Laboratory |
Taxonomy Specialization: | |
Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |