Provider Demographics
NPI:1609278878
Name:SISTEMAS GENOMICOS SL
Entity Type:Organization
Organization Name:SISTEMAS GENOMICOS SL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:647-471-1328
Mailing Address - Street 1:11 DERVOCK CRESCENT
Mailing Address - Street 2:# 312
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M2K1A6
Mailing Address - Country:CA
Mailing Address - Phone:647-471-1328
Mailing Address - Fax:
Practice Address - Street 1:RONDA G. MARCONI, 6
Practice Address - Street 2:
Practice Address - City:PATERNA
Practice Address - State:VALENCIA
Practice Address - Zip Code:46980
Practice Address - Country:ES
Practice Address - Phone:3496-136-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ99D2077066291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory