Provider Demographics
NPI:1134316441
Name:CONFUCIUS PLAZA MEDICAL LABORATORY CORP
Entity Type:Organization
Organization Name:CONFUCIUS PLAZA MEDICAL LABORATORY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERLINDA
Authorized Official - Middle Name:SALCEDO
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-431-4200
Mailing Address - Street 1:42 THROCKMORTON LN
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2572
Mailing Address - Country:US
Mailing Address - Phone:516-464-6121
Mailing Address - Fax:212-625-9338
Practice Address - Street 1:42 THROCKMORTON LN
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2572
Practice Address - Country:US
Practice Address - Phone:516-464-6121
Practice Address - Fax:212-625-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJR47782337454602291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX20311Medicare UPIN
NYL21471Medicare PIN