Provider Demographics
NPI:1760056824
Name:ALAINE DIAGNOSTIC OF NJ LLC
Entity Type:Organization
Organization Name:ALAINE DIAGNOSTIC OF NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:URALIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-805-4406
Mailing Address - Street 1:299 MARKET ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5312
Mailing Address - Country:US
Mailing Address - Phone:631-805-4406
Mailing Address - Fax:
Practice Address - Street 1:299 MARKET ST STE 140
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5312
Practice Address - Country:US
Practice Address - Phone:631-805-4406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory