Provider Demographics
NPI:1104862150
Name:PROTICA, INC.
Entity Type:Organization
Organization Name:PROTICA, INC.
Other - Org Name:PROTICA RESEARCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-832-2000
Mailing Address - Street 1:331 MAPLE AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2139
Mailing Address - Country:US
Mailing Address - Phone:610-994-3852
Mailing Address - Fax:610-944-3288
Practice Address - Street 1:331 MAPLE AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2139
Practice Address - Country:US
Practice Address - Phone:610-994-3852
Practice Address - Fax:610-944-3288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5716960001Medicare NSC