Provider Demographics
NPI:1376014803
Name:PRECISION HEALTH BY SCIENCE
Entity Type:Organization
Organization Name:PRECISION HEALTH BY SCIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-802-7731
Mailing Address - Street 1:7611 MARBLEHEAD LN
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2336
Mailing Address - Country:US
Mailing Address - Phone:301-802-7731
Mailing Address - Fax:
Practice Address - Street 1:4443 LYONS RD STE 211
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4388
Practice Address - Country:US
Practice Address - Phone:549-405-0501
Practice Address - Fax:954-301-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1568426047Medicaid
MD10231583092Medicaid