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General NPI Number Information
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NPI Number | 1205196656
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Entity Type | Organization
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Legal Business Name | ADVANCED PREVENTIVE DIAGNOSTICS, INC
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Dates
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Enumeration Date | 05/19/2012
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Last Update Date | 05/19/2012
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Provider Practice Location Address
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Address Line | 10373 DEMOCRACY LN B
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City | FAIRFAX
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State | VA
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Zip | 22030-2586
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Country | US
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Telephone | 347-264-7949
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Fax | 571-442-8272
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Provider Business Mailing Address
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Address Line | 10373 DEMOCRACY LN STE B
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City | FAIRFAX
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State | VA
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Zip | 22030-2588
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Country | US
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Telephone | 347-264-7949
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Fax | 571-442-8272
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SALEHUDDIN M ISA
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Credential |
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Telephone | 347-264-7949
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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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