Healthcare Provider Details
I. General information
NPI: 1447913231
Provider Name (Legal Business Name): RFC NY LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
315 W 57TH ST STE 208
NEW YORK NY
10019-3149
US
IV. Provider business mailing address
315 W 57TH ST STE 208
NEW YORK NY
10019-3149
US
V. Phone/Fax
- Phone: 203-557-9696
- Fax:
- Phone: 203-557-9696
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZAHER
MERHI
Title or Position: CEO, OWNER
Credential: MD
Phone: 203-557-9696