Provider Demographics
NPI:1700240405
Name:PHOSPHORUS DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:PHOSPHORUS DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BISIGNANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-746-7423
Mailing Address - Street 1:PO BOX 4668
Mailing Address - Street 2:#29926
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10163-4668
Mailing Address - Country:US
Mailing Address - Phone:646-470-7422
Mailing Address - Fax:
Practice Address - Street 1:400 PLAZA DR FL 4
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3605
Practice Address - Country:US
Practice Address - Phone:646-470-7422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOSPHORUS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-08
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory