CGC Genetics Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

COS00800249 Issued in CA

Legal business name

CGC GENETICS INC.

Practice address

185 S Orange Ave
F661
Newark, NJ 07103-2757

Phone

(973) 623-1264

Fax

(973) 623-1266

NPI assigned

Mar 4, 2013

Last updated

Mar 4, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prof. Purificacao Tavares, M.D., PHD

Title

Ceo

Phone

(973) 623-1264

Specialties & licenses 1

Addresses

Tax ID family

CGC Genetics Inc2 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.

• CGC Genetics Inc.

  • Clinical Medical Laboratory
  • Newark, NJ
  • NPI 1720363476
  NPD tax ID

Locations

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1467793208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "F661",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-623-1264",
            "fax_number": "973-623-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "F661",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-623-1264",
            "fax_number": "973-623-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGC GENETICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "TAVARES",
        "authorized_official_first_name": "PURIFICACAO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-623-1264",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "M.D., PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "COS00800249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cerebral Palsy of North Jersey
• Cerebral Palsy of North Jersey
• Janine Paola Alano Cerilla, FNP-BC
• Mireya S Cervantes, MD
• Lissette Maria Cespedes, M.D.
• CGC Genetics Inc.
• Daniel Nemer Chaaban, MSN, FNP
• Suneeta E. Chacko-Varkey, MD
• Davis Chacko
• Herberth Chacon, LSW

• Clinical Medical Laboratory in Newark, NJ
• Providers in Newark, 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 Mar 4, 2013; 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.