Courtagen Life Sciences, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

APPLIED FOR Issued in MA

Legal business name

COURTAGEN LIFE SCIENCES, INC.

Practice address

8 Cabot Rd
Suite 2000
Woburn, MA 01801-1004

Phone

(877) 395-7608

Fax

(617) 249-0394

NPI assigned

Jan 4, 2012

Organization subpart

No

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

Authorized official

Name

Richard Brian McKernan

Title

Ceo

Phone

(617) 892-7179

Specialties & licenses 1

Addresses

Other names 1

• Courtagen Diagnostics Laboratory Doing business as

Locations

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1144590449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CABOT RD",
            "address_2": "SUITE 2000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011004",
            "telephone_number": "877-395-7608",
            "fax_number": "617-249-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CABOT RD",
            "address_2": "SUITE 2000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011004",
            "telephone_number": "877-395-7608",
            "fax_number": "617-249-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTAGEN LIFE SCIENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "MCKERNAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-892-7179"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Courtagen Diagnostics Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Costello, MS BCBA LABA
• Thomas H Costello, MD
• Patricia Cotter, MA
• Nancy B. Cottrill, DVM
• Miranda Hicks Courant-Morgan, BCBA
• Angelina Christine Couzelis, LMHC
• Danielle Coveno
• Edward Cowal, LICSW
• Amy Cowley, COTA
• Cpte Senior Therapy Services Inc

• Clinical Medical Laboratory in Woburn, MA
• Providers in Woburn, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.