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General NPI Number Information
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NPI Number | 1639449986
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Entity Type | Organization
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Legal Business Name | ORI MEDICAL TECHNOLOGY INSTITUTE
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 4405 BERGENLINE AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-5003
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Country | US
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Telephone | 201-633-0277
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Fax | 201-633-0281
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Provider Business Mailing Address
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Address Line | 4405 BERGENLINE AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-5003
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Country | US
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Telephone | 201-633-0277
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Fax | 201-633-0281
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLGA SUAU
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Credential |
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Telephone | 201-633-0277
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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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