Provider Demographics
NPI:1720363476
Name:CGC GENETICS INC.
Entity Type:Organization
Organization Name:CGC GENETICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF BUSINESS & SCIENTIFIC CONSULT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:877-242-5229
Mailing Address - Street 1:211 WARREN STREET
Mailing Address - Street 2:SUITE 317
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103
Mailing Address - Country:US
Mailing Address - Phone:877-242-5229
Mailing Address - Fax:973-623-1266
Practice Address - Street 1:211 WARREN STREET
Practice Address - Street 2:SUITE 317
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:877-242-5229
Practice Address - Fax:973-623-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory