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General NPI Number Information
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NPI Number | 1619648987
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Entity Type | Organization
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Legal Business Name | NANOBIOSYM GLOBAL INITIATIVE LLC
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 245 FIRST ST STE 175
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City | CAMBRIDGE
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State | MA
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Zip | 02142-1292
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Country | US
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Telephone | 781-391-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 245 FIRST ST 18TH FLOOR - ACCTS PAYABLE
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City | CAMBRIDGE
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State | MA
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Zip | 02142
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Country | US
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Telephone | 617-669-6359
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANITA GOEL
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Credential | MD-PHD
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Telephone | 617-669-6359
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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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