Organization Name: | ST. CROIX DIAGNOSTICS, LLC |
NPI Number: | 1346672854 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARAKERE B PRASAD (OWNER) |
Mailing Address: | 4a & 4 Aa Estate La Grande Princesse Christiansted |
State: | VI US |
Postal Code: | 00820 |
Phone Number: | 3407187788 |
Fax Number: | 3407189130 |
NPI Enumeration Date: | 08/07/2013 |
NPI Last Update Date: | 08/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 621 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |