Provider Demographics
NPI:1568127546
Name:R.TRADES LLC
Entity Type:Organization
Organization Name:R.TRADES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMY
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:TORIBIO
Authorized Official - Last Name:TORRES CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-879-2369
Mailing Address - Street 1:45 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-2546
Mailing Address - Country:US
Mailing Address - Phone:631-879-2369
Mailing Address - Fax:
Practice Address - Street 1:45 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2546
Practice Address - Country:US
Practice Address - Phone:631-879-2369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory