Provider Demographics
NPI:1114599842
Name:BIORUSH INC
Entity Type:Organization
Organization Name:BIORUSH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MEDICAL LOGISTICS
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:914-510-2415
Mailing Address - Street 1:3640 JOHNSON AVE STE PR1N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1617
Mailing Address - Country:US
Mailing Address - Phone:914-510-2415
Mailing Address - Fax:
Practice Address - Street 1:3640 JOHNSON AVE STE PR1N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1617
Practice Address - Country:US
Practice Address - Phone:914-510-2415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
No342000000XTransportation ServicesTransportation Network CompanyGroup - Multi-Specialty