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General NPI Number Information
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NPI Number | 1568641512
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Entity Type | Organization
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Legal Business Name | REPROGENETICS
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 3 REGENT ST SUITE 301
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1668
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Country | US
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Telephone | 973-436-5017
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Fax | 973-992-1423
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Provider Business Mailing Address
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Address Line | 3 REGENT ST SUITE 301
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City | LIVINGSTON
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State | NJ
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Zip | 07039
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Country | US
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Telephone | 973-436-5000
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Fax | 973-992-1423
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Authorized Official
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Title or Position | CFO
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Name | ALAN TUCKER
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Credential |
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Telephone | 203-601-9808
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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 | 31D1054821
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License Number State | NJ
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