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General NPI Number Information
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NPI Number | 1306655642
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Entity Type | Organization
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Legal Business Name | ALLELICA, INC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 7 FIELDSTONE LN
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City | NATICK
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State | MA
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Zip | 01760-5560
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Country | US
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Telephone | 781-258-1454
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Fax |
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Provider Business Mailing Address
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Address Line | 447 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10013-2562
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Country | US
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Telephone | 202-949-2834
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Fax |
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Authorized Official
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Title or Position | CEO & CO-FOUNDER
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Name | GIORDANO BOTTA
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Credential | PHD
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Telephone | 415-964-5914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QG0250X
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Taxonomy Name | Genetics Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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