Provider Demographics
NPI:1598402711
Name:NYC LABORATORIES PR LLC
Entity Type:Organization
Organization Name:NYC LABORATORIES PR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-641-2125
Mailing Address - Street 1:560 HUDSON ST FL 3
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6655
Mailing Address - Country:US
Mailing Address - Phone:201-641-2125
Mailing Address - Fax:
Practice Address - Street 1:15 E 40TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0401
Practice Address - Country:US
Practice Address - Phone:551-298-3432
Practice Address - Fax:212-888-6024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NYC LABORATORIES PLUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physicianGroup - Single Specialty