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General NPI Number Information
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NPI Number | 1629737200
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Entity Type | Organization
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Legal Business Name | DNTP LABORATORY LLC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 03/19/2022
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Provider Practice Location Address
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Address Line | 780 CEDAR LN SIDE ENTRANCE
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City | TEANECK
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State | NJ
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Zip | 07666-1706
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Country | US
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Telephone | 347-469-9491
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Fax |
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Provider Business Mailing Address
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Address Line | 780 CEDAR LN SIDE ENTRANCE
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City | TEANECK
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State | NJ
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Zip | 07666-1706
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Country | US
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Telephone | 347-469-9491
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MD RASEL AHSAN
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Credential |
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Telephone | 347-469-9491
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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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Taxonomy #2
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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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