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General NPI Number Information
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NPI Number | 1306925771
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Entity Type | Organization
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Legal Business Name | LINDENHURST MEDICAL LABORATORY INC
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 103 SCHOOL STREET
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City | LINDENHURST
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State | NY
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Zip | 11757-3710
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Country | US
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Telephone | 631-226-2626
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Fax | 631-226-2720
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Provider Business Mailing Address
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Address Line | 103 SCHOOL STREET
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City | LINDENHURST
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State | NY
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Zip | 11757-3710
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Country | US
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Telephone | 631-226-2626
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Fax | 631-226-2720
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES A SEIBERT SR.
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Credential |
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Telephone | 631-226-2626
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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 | PFI2316
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License Number State | NY
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