Provider Demographics
NPI:1801483383
Name:PRAXIS GENOMICS LLC
Entity type:Organization
Organization Name:PRAXIS GENOMICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:L
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:914-343-8999
Mailing Address - Street 1:6115 PEACHTREE DUNWOODY RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5684
Mailing Address - Country:US
Mailing Address - Phone:678-837-4022
Mailing Address - Fax:
Practice Address - Street 1:6115 PEACHTREE DUNWOODY RD STE 220
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5684
Practice Address - Country:US
Practice Address - Phone:678-837-4022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory