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General NPI Number Information
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NPI Number | 1710477344
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Entity Type | Organization
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Legal Business Name | ATVIVO LLC
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 110B MEADOWLANDS PKWY STE 101
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City | SECAUCUS
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State | NJ
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Zip | 07094-2308
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Country | US
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Telephone | 844-788-1478
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Fax |
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Provider Business Mailing Address
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Address Line | 955 YONKERS AVE STE 19
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City | YONKERS
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State | NY
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Zip | 10704-3063
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Country | US
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Telephone | 949-328-7805
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MOSHE KRAUS
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Credential |
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Telephone | 844-788-1478
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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 | NY
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