MEDICARE: PRECISEDX INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1164107249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISEDX INC

Provider Business Mailing Address
First Line	:	810 SEVENTH AVE STE 515
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-5876
Country	:	US
Telephone Number	:	646-818-9330
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 SEVENTH AVE STE 515
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-5876
Country	:	US
Telephone Number	:	646-818-9330
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	KRISTIAN CRUZ
Credential	:
Telephone Number	:	313-663-0295

Provider Enumeration Date	:	06/16/2023
Last Update Date	:	11/19/2024

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Directions to “PRECISEDX INC ” Practice Location

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