Provider Demographics
NPI:1518291129
Name:APPLE DIAGNOSTICS LAB
Entity Type:Organization
Organization Name:APPLE DIAGNOSTICS LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NAEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-222-8800
Mailing Address - Street 1:233 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2504
Mailing Address - Country:US
Mailing Address - Phone:908-222-8800
Mailing Address - Fax:908-222-0004
Practice Address - Street 1:233 DURHAM AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2504
Practice Address - Country:US
Practice Address - Phone:908-222-8800
Practice Address - Fax:908-222-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103728249Medicaid
NJ0376787Medicaid