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General NPI Number Information
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NPI Number | 1326856287
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Entity Type | Organization
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Legal Business Name | HERANOVA LIFESCIENCES INC
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Dates
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Enumeration Date | 12/24/2024
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 5 MASON
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City | IRVINE
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State | CA
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Zip | 92618-2552
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Country | US
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Telephone | 866-225-9195
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Fax |
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Provider Business Mailing Address
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Address Line | 2 BURLINGTON WOODS DR STE 100
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City | BURLINGTON
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State | MA
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Zip | 01803-4551
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER - DIAGNOSTICS
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Name | DR. FARIDEH BISCHOFF
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Credential | PHD
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Telephone | 718-715-9967
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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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