Organization Active NPI

Medex Diagnostic and Treatment Center LLC

  • Clinical Pathology/Laboratory Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1083200174
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
Legal business name
MEDEX DIAGNOSTIC AND TREATMENT CENTER LLC
Practice address
11129 Queens Blvd
Forest Hills, NY 11375-5553
Phone
(718) 275-8900
Fax
(718) 785-0430
NPI assigned
Dec 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Oleg Aronov
Title
Managing Member
Phone
(718) 275-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X Primary

Addresses

Primary practice location

11129 Queens Blvd
Forest Hills, NY 11375-5553

Mailing address

11129 Queens Blvd
Forest Hills, NY 11375-5553
Phone (718) 275-8900

National Provider Directory

National Provider Directory
Tax ID family
Medex Diagnostic and Treatment Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1083200174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11129 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755553",
            "telephone_number": "718-275-8900",
            "fax_number": "718-785-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11129 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755553",
            "telephone_number": "718-275-8900",
            "fax_number": "718-785-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEX DIAGNOSTIC AND TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "ARONOV",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "718-275-8900"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.