Provider Demographics
NPI:1063008886
Name:REOPEN DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:REOPEN DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BADAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-831-3555
Mailing Address - Street 1:4518 COURT SQ
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2955
Mailing Address - Country:US
Mailing Address - Phone:332-214-3323
Mailing Address - Fax:888-473-2963
Practice Address - Street 1:4518 COURT SQ
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2955
Practice Address - Country:US
Practice Address - Phone:332-214-3323
Practice Address - Fax:888-473-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty