Universal Diagnostic Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

UNIVERSAL DIAGNOSTIC LABORATORY, INC.

Practice address

1414 Newkirk Ave
Brooklyn, NY 11226-6522

Phone

(718) 859-4777

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Damo Baligo

Title

Controller

Phone

(718) 781-6560

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1104996248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12056 MOUNT VERNON AVE",
            "address_2": "SUITE 358",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135116",
            "telephone_number": "866-455-5700",
            "fax_number": "909-824-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 NEWKIRK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266522",
            "telephone_number": "718-859-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL DIAGNOSTIC LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "BALIGO",
        "authorized_official_first_name": "DAMO",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "718-781-6560",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Medical Laboratory in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.