Provider Demographics
NPI:1932562212
Name:PATHGENIX DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:PATHGENIX DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZUJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-240-2858
Mailing Address - Street 1:214 AVENUE P
Mailing Address - Street 2:6A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6573
Mailing Address - Country:US
Mailing Address - Phone:347-240-2858
Mailing Address - Fax:
Practice Address - Street 1:3370 PRINCE ST
Practice Address - Street 2:CA21
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2745
Practice Address - Country:US
Practice Address - Phone:347-240-2858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-03
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238751291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory