Provider Demographics
NPI:1881200079
Name:CORAL GENOMICS, INC.
Entity Type:Organization
Organization Name:CORAL GENOMICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ATRAY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXIT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-474-5612
Mailing Address - Street 1:953 INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3007
Mailing Address - Country:US
Mailing Address - Phone:516-474-5612
Mailing Address - Fax:
Practice Address - Street 1:953 INDIANA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-3007
Practice Address - Country:US
Practice Address - Phone:516-474-5612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic PathologyGroup - Multi-Specialty