Provider Demographics
NPI:1093749087
Name:ACULABS INC
Entity Type:Organization
Organization Name:ACULABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUDAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-777-2588
Mailing Address - Street 1:2 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1248
Mailing Address - Country:US
Mailing Address - Phone:732-777-2588
Mailing Address - Fax:732-777-2601
Practice Address - Street 1:2 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1248
Practice Address - Country:US
Practice Address - Phone:732-777-2588
Practice Address - Fax:732-777-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ00006219291U00000X
335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2703700Medicaid
NJ302785Medicare ID - Type Unspecified