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General NPI Number Information
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NPI Number | 1255796686
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Entity Type | Organization
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Legal Business Name | ARCHER MEDICAL DIAGNOSTIC TESTING
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 3799 COMMERCE CT STE 300
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-2027
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Country | US
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Telephone | 716-205-0433
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Fax | 716-706-1416
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Provider Business Mailing Address
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Address Line | 3799 COMMERCE CT STE 300
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-2027
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Country | US
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Telephone | 716-205-0433
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Fax | 716-706-1416
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STEPHEN HUTTON
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Credential |
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Telephone | 585-455-9178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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