Provider Demographics
NPI:1770978314
Name:HISTOGENETICS LLC
Entity type:Organization
Organization Name:HISTOGENETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:CEM
Authorized Official - Middle Name:
Authorized Official - Last Name:SONMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-762-0300
Mailing Address - Street 1:300 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-2562
Mailing Address - Country:US
Mailing Address - Phone:914-762-0300
Mailing Address - Fax:914-762-4441
Practice Address - Street 1:300 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2562
Practice Address - Country:US
Practice Address - Phone:914-762-0300
Practice Address - Fax:914-762-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory