Provider Demographics
NPI:1518257237
Name:PRECIPIO LLC
Entity Type:Organization
Organization Name:PRECIPIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-787-7888
Mailing Address - Street 1:4 SCIENCE PARK
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-1962
Mailing Address - Country:US
Mailing Address - Phone:203-787-7888
Mailing Address - Fax:203-901-1289
Practice Address - Street 1:4 SCIENCE PARK
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-1963
Practice Address - Country:US
Practice Address - Phone:203-787-7888
Practice Address - Fax:203-901-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCL-0679291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD300069332Medicare PIN