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General NPI Number Information
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NPI Number | 1356656862
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Entity Type | Organization
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Legal Business Name | CORIELL INSTITUTE FOR MEDICAL RESEARCH
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 403 HADDON AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-1505
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Country | US
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Telephone | 856-966-7377
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Fax | 856-964-0254
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Provider Business Mailing Address
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Address Line | 403 HADDON AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-1505
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Country | US
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Telephone | 856-966-7377
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Fax | 856-964-0254
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. EDWARD JOHN PALLIES
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Credential | MS
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Telephone | 856-757-4826
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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 | 00015734
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License Number State | NJ
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