Provider Demographics
NPI:1265735443
Name:NEOLOMED INC.
Entity type:Organization
Organization Name:NEOLOMED INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBOURZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYVANDI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-274-9450
Mailing Address - Street 1:1 DEER PARK DR
Mailing Address - Street 2:SUITE Q
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-1920
Mailing Address - Country:US
Mailing Address - Phone:908-274-9450
Mailing Address - Fax:732-274-9452
Practice Address - Street 1:1 DEER PARK DR
Practice Address - Street 2:SUITE Q
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-1920
Practice Address - Country:US
Practice Address - Phone:908-274-9450
Practice Address - Fax:732-274-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory