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General NPI Number Information
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NPI Number | 1033654892
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Entity Type | Organization
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Legal Business Name | MICROPATH, LLC
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 2325 31ST ST SUITE 701
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City | ASTORIA
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State | NY
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Zip | 11105-2808
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Country | US
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Telephone | 929-269-1566
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Fax | 718-932-3194
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Provider Business Mailing Address
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Address Line | 2325 31ST ST SUITE 701
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City | ASTORIA
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State | NY
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Zip | 11105-2808
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Country | US
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Telephone | 929-269-1566
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Fax | 718-932-3194
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARRY OBADIAH
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Credential | M.D.
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Telephone | 929-269-1566
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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 |
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License Number State |
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