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General NPI Number Information
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NPI Number | 1295554012
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Entity Type | Organization
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Legal Business Name | BROOKLYN INNOSEQ INC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-0002
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Country | US
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Telephone | 860-679-2792
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Fax |
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Provider Business Mailing Address
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Address Line | 14127 79TH AVE APT 1D
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City | FLUSHING
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State | NY
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Zip | 11367-3673
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Country | US
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Telephone | 646-945-8999
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS NINI FAN
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Credential |
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Telephone | 646-945-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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