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General NPI Number Information
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NPI Number | 1679228100
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Entity Type | Organization
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Legal Business Name | ELGON BUSINESS GROUP
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 14B SEVEN SPRINGS LN
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City | BURLINGTON
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State | MA
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Zip | 01803-5123
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Country | US
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Telephone | 781-308-1345
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Fax |
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Provider Business Mailing Address
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Address Line | 14B SEVEN SPRINGS LN
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City | BURLINGTON
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State | MA
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Zip | 01803-5123
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Country | US
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Telephone | 781-308-1345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HARRIET KIDDU
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Credential |
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Telephone | 781-308-1345
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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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