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General NPI Number Information
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NPI Number | 1003023888
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Entity Type | Organization
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Legal Business Name | NELCO LABORATORIES INC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 154 BROOK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-7205
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Country | US
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Telephone | 631-242-3662
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Fax | 631-242-3290
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Provider Business Mailing Address
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Address Line | 154 BROOK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-7205
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Country | US
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Telephone | 631-242-3662
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Fax | 631-242-3290
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. NOELLE PARK
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Credential |
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Telephone | 631-242-3662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 101193
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License Number State | NY
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