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General NPI Number Information
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NPI Number | 1720363476
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Entity Type | Organization
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Legal Business Name | CGC GENETICS INC.
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 211 WARREN STREET SUITE 317
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City | NEWARK
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State | NJ
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Zip | 07103
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Country | US
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Telephone | 877-242-5229
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Fax | 973-623-1266
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Provider Business Mailing Address
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Address Line | 211 WARREN STREET SUITE 317
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City | NEWARK
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State | NJ
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Zip | 07103
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Country | US
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Telephone | 877-242-5229
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Fax | 973-623-1266
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Authorized Official
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Title or Position | CHIEF BUSINESS & SCIENTIFIC CONSULT
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Name | PETER TOLIAS
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Credential | PH.D.
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Telephone | 877-242-5229
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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 | NJ
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