Healthcare Provider Details

I. General information

NPI: 1932816709
Provider Name (Legal Business Name): COVID TEST NYC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25306 HILLSIDE AVE
BELLEROSE NY
11426-2152
US

IV. Provider business mailing address

25306 HILLSIDE AVE
BELLEROSE NY
11426-2152
US

V. Phone/Fax

Practice location:
  • Phone: 718-500-7178
  • Fax:
Mailing address:
  • Phone: 718-500-7178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAZIULMUNIR KAZI
Title or Position: OWNER
Credential:
Phone: 718-500-7178