Healthcare Provider Details
I. General information
NPI: 1306655642
Provider Name (Legal Business Name): ALLELICA, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/02/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
945 CONCORD ST STE 211
FRAMINGHAM MA
01701-4613
US
IV. Provider business mailing address
447 BROADWAY
NEW YORK NY
10013-2562
US
V. Phone/Fax
- Phone: 781-258-1454
- Fax:
- Phone: 202-949-2834
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QG0250X |
| Taxonomy | Genetics Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GIORDANO
BOTTA
Title or Position: CEO & CO-FOUNDER
Credential: PHD
Phone: 415-964-5914