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General NPI Number Information
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NPI Number | 1427586726
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Entity Type | Organization
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Legal Business Name | O-K DIAGNOSTICS LLC
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4176 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6739
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Country | US
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Telephone | 718-698-3030
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Fax | 718-494-1095
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Provider Business Mailing Address
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Address Line | 4176 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6739
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Country | US
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Telephone | 718-698-3030
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Fax | 718-494-1095
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. DARYA FEKLISTOVA
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Credential |
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Telephone | 917-913-0240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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