Provider Demographics
NPI:1881450724
Name:FRONT ROW LABS LLC
Entity type:Organization
Organization Name:FRONT ROW LABS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEREDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-847-2424
Mailing Address - Street 1:503 WASHINGTON AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2153
Mailing Address - Country:US
Mailing Address - Phone:215-847-2424
Mailing Address - Fax:
Practice Address - Street 1:503 WASHINGTON AVE STE 2C
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2153
Practice Address - Country:US
Practice Address - Phone:215-847-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No332U00000XSuppliersHome Delivered MealsGroup - Multi-Specialty