Provider Demographics
NPI:1396905717
Name:BIO-MEDICAL LABORATORY INC
Entity type:Organization
Organization Name:BIO-MEDICAL LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIGLIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:HCLD
Authorized Official - Phone:732-651-0333
Mailing Address - Street 1:561 CRANBURY RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5400
Mailing Address - Country:US
Mailing Address - Phone:732-651-0333
Mailing Address - Fax:732-254-6311
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:SUITE K
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:732-651-0333
Practice Address - Fax:732-254-6311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIO-MEDICAL LABORATORY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-10
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5895293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ021404Medicare PIN