Provider Demographics
NPI:1629702824
Name:GEZUNT DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:GEZUNT DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-213-7423
Mailing Address - Street 1:50 CHESTNUT RIDGE RD # 221
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1814
Mailing Address - Country:US
Mailing Address - Phone:845-213-7423
Mailing Address - Fax:
Practice Address - Street 1:50 CHESTNUT RIDGE RD # 221
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1814
Practice Address - Country:US
Practice Address - Phone:845-213-7423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory