MEDICARE: GOOD NIGHT DIAGNOSTIC CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1730130501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD NIGHT DIAGNOSTIC CENTER, INC

Provider Business Mailing Address
First Line	:	1331 E WYOMING AVE
Second Line	:	SUITE 3010
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	267-716-8127
Fax Number	:

Provider Business Practice Location Address
First Line	:	1331 E WYOMING AVE
Second Line	:	SUITE 3010
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	267-716-8127
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. KAREN HARHI
Credential	:	LPN
Telephone Number	:	267-716-8127

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/21/2022

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