NPIMap

Organization Active NPI

Enzo Clinical Labs, Inc.

  • Clinical Medical Laboratory
  • Farmingdale, NY
National Provider Identifier
1235234402
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
21685150A050 Issued in NY
Legal business name
ENZO CLINICAL LABS, INC.
Practice address
60 Executive Blvd
Farmingdale, NY 11735-4710
Phone
(631) 755-5566
Fax
(631) 755-5566
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Dieter Schapfel, M.D.
Title
Chief Scientific Officer/Medical Di
Phone
(631) 755-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 21685150A050 NY Primary

Addresses

Primary practice location

60 Executive Blvd
Farmingdale, NY 11735-4710

Mailing address

60 Executive Blvd
Farmingdale, NY 11735-4710
Phone (631) 755-5500

Other identifiers 7

IdentifierTypeStateIssuer
00635754MedicaidNY
NY2026OtherHEALTHNET
0086442OtherGROUP HEALTH INC.
162350OtherELDER PLAN
690001935OtherMEDICARE RAILROAD
1000002976OtherAFFINITY HEALTH
EZNOCLINICALOtherCMO MONTEFIORE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000390 NY Part B Supplier - Independent Clinical Laboratory 2961593512 Practice locations: Farmingdale, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1235234402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 EXECUTIVE BLVD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354710",
            "telephone_number": "631-755-5500",
            "fax_number": "631-755-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 EXECUTIVE BLVD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354710",
            "telephone_number": "631-755-5566",
            "fax_number": "631-755-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENZO CLINICAL LABS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHAPFEL",
        "authorized_official_first_name": "DIETER",
        "authorized_official_title_or_position": "CHIEF SCIENTIFIC OFFICER/MEDICAL DI",
        "authorized_official_telephone_number": "631-755-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "21685150A050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00635754",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "NY2026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH INC.",
            "identifier": "0086442",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER PLAN",
            "identifier": "162350",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "690001935",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFINITY HEALTH",
            "identifier": "1000002976",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMO MONTEFIORE",
            "identifier": "EZNOCLINICAL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.