Providence Healthcare Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROVIDENCE HEALTHCARE DIAGNOSTICS

Practice address

320 Park Ave
Plainfield, NJ 07060-4230

Phone

(908) 444-0485

NPI assigned

Jan 27, 2022

Organization subpart

No

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

Authorized official

Name

Miss Naomie Dorilas

Title

Owner

Phone

(908) 444-0485

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1417600834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PARK AVE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070604230",
            "telephone_number": "908-444-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PARK AVE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070604230",
            "telephone_number": "908-444-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTHCARE DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "DORILAS",
        "authorized_official_first_name": "NAOMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-444-0485",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Plainfield, NJ
• Providers in Plainfield, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.