Provider Demographics
NPI:1710304050
Name:RECOMBINE
Entity Type:Organization
Organization Name:RECOMBINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-243-2974
Mailing Address - Street 1:75 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1350
Mailing Address - Country:US
Mailing Address - Phone:800-243-2974
Mailing Address - Fax:
Practice Address - Street 1:3 REGENT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1668
Practice Address - Country:US
Practice Address - Phone:855-687-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOPERGENOMICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-25
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory