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General NPI Number Information
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NPI Number | 1568084382
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Entity Type | Organization
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Legal Business Name | AMERICAN GENETICS INSTITUTE INC.
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 4731 W ATLANTIC AVE STE B-21
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3897
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Country | US
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Telephone | 855-837-8331
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Fax |
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Provider Business Mailing Address
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Address Line | 80 MONATIQUOT AVE
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City | BRAINTREE
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State | MA
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Zip | 02184-4641
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Country | US
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Telephone | 617-905-4829
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CORAIN E MCGINN
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Credential |
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Telephone | 617-905-4829
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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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