Provider Demographics
NPI:1265740476
Name:ACCUVANCE DIAGNOSTICS CORPORATION
Entity type:Organization
Organization Name:ACCUVANCE DIAGNOSTICS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JABEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-782-5151
Mailing Address - Street 1:1040 MAIN ST
Mailing Address - Street 2:SUITE B1
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2212
Mailing Address - Country:US
Mailing Address - Phone:973-782-5151
Mailing Address - Fax:800-965-4031
Practice Address - Street 1:1040 MAIN ST.
Practice Address - Street 2:SUITE B1
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503
Practice Address - Country:US
Practice Address - Phone:973-782-5151
Practice Address - Fax:800-965-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory