Provider Demographics
NPI:1629737200
Name:DNTP LABORATORY LLC
Entity Type:Organization
Organization Name:DNTP LABORATORY LLC
Other - Org Name:DNTP LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MD
Authorized Official - Middle Name:RASEL
Authorized Official - Last Name:AHSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-469-9491
Mailing Address - Street 1:780 CEDAR LN SIDE ENTRANCE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1706
Mailing Address - Country:US
Mailing Address - Phone:347-469-9491
Mailing Address - Fax:
Practice Address - Street 1:780 CEDAR LN SIDE ENTRANCE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1706
Practice Address - Country:US
Practice Address - Phone:347-469-9491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No293D00000XLaboratoriesPhysiological Laboratory