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General NPI Number Information
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NPI Number | 1871953109
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Entity Type | Organization
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Legal Business Name | SENTRA LABORATORIES INC/
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 40 BAY SHORE AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-7929
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Country | US
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Telephone | 630-417-7862
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Fax |
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Provider Business Mailing Address
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Address Line | 40 BAY SHORE AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-7929
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Country | US
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Telephone | 630-417-7862
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHARLES LEVY
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Credential |
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Telephone | 630-417-7862
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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 | PFI# 8899
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License Number State | NY
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