Provider Demographics
NPI:1578638060
Name:MOLECULAR MEDICINE INC.
Entity Type:Organization
Organization Name:MOLECULAR MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JUCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-586-4111
Mailing Address - Street 1:95 E MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2158
Mailing Address - Country:US
Mailing Address - Phone:973-586-4111
Mailing Address - Fax:973-586-8466
Practice Address - Street 1:95 E MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2158
Practice Address - Country:US
Practice Address - Phone:973-586-4111
Practice Address - Fax:973-586-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory