Healthcare Provider Details

I. General information

NPI: 1093749087
Provider Name (Legal Business Name): ACULABS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 KENNEDY BLVD
EAST BRUNSWICK NJ
08816-1248
US

IV. Provider business mailing address

2 KENNEDY BLVD
EAST BRUNSWICK NJ
08816-1248
US

V. Phone/Fax

Practice location:
  • Phone: 732-777-2588
  • Fax: 732-777-2601
Mailing address:
  • Phone: 732-777-2588
  • Fax: 732-777-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number00006219
License Number StateNJ

VIII. Authorized Official

Name: MR. PETER GUDAITIS
Title or Position: PRESIDENT
Credential:
Phone: 732-777-2588