MEDICARE: GENETIX MEDICAL LAB 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1174453005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENETIX MEDICAL LAB INC

Provider Business Mailing Address
First Line	:	2744 SAW MILL RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-2329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2744 SAW MILL RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-2329
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SYED HUSSAIN
Credential	:
Telephone Number	:	999-999-9999

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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