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General NPI Number Information
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NPI Number | 1942505904
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Entity Type | Organization
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Legal Business Name | CANCER THERAPEUTICS INNOVATION GROUP
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 777 3RD AVE SUITE 14A
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City | NEW YORK
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State | NY
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Zip | 10017-1401
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Country | US
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Telephone | 212-355-3755
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Fax |
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Provider Business Mailing Address
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Address Line | 777 3RD AVE SUITE 14A
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City | NEW YORK
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State | NY
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Zip | 10017-1401
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Country | US
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Telephone | 212-355-3755
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. PETROS GIANNIKOPOULOS
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Credential |
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Telephone | 212-355-3755
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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 | 264295
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License Number State | NY
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