Provider Demographics
NPI:1164799763
Name:CROSS ISLAND DIAGNOSTIC AND RESEARCH LABORATORY INC
Entity Type:Organization
Organization Name:CROSS ISLAND DIAGNOSTIC AND RESEARCH LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBASIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADHIKARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-270-7675
Mailing Address - Street 1:3269 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1932
Mailing Address - Country:US
Mailing Address - Phone:516-270-7675
Mailing Address - Fax:516-307-9510
Practice Address - Street 1:3269 HEMPSTEAD TURNPIKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1175
Practice Address - Country:US
Practice Address - Phone:516-270-7675
Practice Address - Fax:516-307-9510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-27
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235564291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory