Ridgewood Diagnostic Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

31D2109691 Issued in NJ

Legal business name

RIDGEWOOD DIAGNOSTIC LABORATORY, LLC

Practice address

126 State Street
2ND Floor
Hackensack, NJ 07601

Phone

(973) 542-2343

Fax

(201) 632-6548

NPI assigned

Aug 31, 2015

Last updated

Nov 20, 2018By 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

Alexandr Zaitsev, M.D.NPI 1588635791

Title

President

Phone

(862) 703-0506

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexandr Zaitsev, MD

  • Anesthesiology Physician
  • Elizabeth, NJ
  • NPI 1588635791
  NPD (past) Authorized official

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542672000000",
    "number": "1568839173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 STATE STREET",
            "address_2": "2ND FLOOR",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "973-542-2343",
            "fax_number": "201-632-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 STATE STREET",
            "address_2": "2ND FLOOR",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "973-542-2343",
            "fax_number": "201-632-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD DIAGNOSTIC LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2018-11-20",
        "status": "A",
        "authorized_official_last_name": "ZAITSEV",
        "authorized_official_first_name": "ALEXANDR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "862-703-0506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "31D2109691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela E Riano, NP
• Charles Anthony Riccobono, MD
• Gary A. Rich
• Lisa Richter
• Aliza Sara Ricklis, MS
• Hannah Elizabeth Riede, LAC
• Stacey Rifkin-Zenenberg, D.O.
• Muhamad Raed Rihani, M.D.
• Cesar Rincon
• Donna Riola

• Clinical Medical Laboratory in Hackensack, NJ
• Providers in Hackensack, 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 Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.