Provider Demographics
NPI:1780431452
Name:TL BIOLOGICS INC.
Entity type:Organization
Organization Name:TL BIOLOGICS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LORE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:914-720-0608
Mailing Address - Street 1:110 HAROLD AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1226
Mailing Address - Country:US
Mailing Address - Phone:914-490-3703
Mailing Address - Fax:845-534-3452
Practice Address - Street 1:1049 YONKERS AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3083
Practice Address - Country:US
Practice Address - Phone:914-720-0806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service