Provider Demographics
NPI:1558609008
Name:BIODIAGNOSTIC LABS, INC
Entity Type:Organization
Organization Name:BIODIAGNOSTIC LABS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERSHON
Authorized Official - Middle Name:J
Authorized Official - Last Name:SONTAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-847-2660
Mailing Address - Street 1:2380 EAST 22 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:516-847-2660
Mailing Address - Fax:631-297-1333
Practice Address - Street 1:2380 EAST 22 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:516-847-2660
Practice Address - Fax:631-297-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3963291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory