Accumed Diagnostic Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ACCUMED DIAGNOSTIC LABORATORY INC

Practice address

540 Bordentown Avenue
Second Floor Suite 4
South Amboy, NJ 08879

Phone

(732) 721-3763

Fax

(732) 721-7600

NPI assigned

Oct 23, 2006

Last updated

Aug 22, 2020By 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

Mr. Stanley Levy

Title

Director Owner

Phone

(732) 721-3763

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659454767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVENUE",
            "address_2": "SECOND FLOOR SUITE 4",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "08879",
            "telephone_number": "732-721-3763",
            "fax_number": "732-721-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVENUE",
            "address_2": "SECOND FLOOR SUITE 4",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "08879",
            "telephone_number": "732-721-3763",
            "fax_number": "732-721-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCUMED DIAGNOSTIC LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "DIRECTOR OWNER",
        "authorized_official_telephone_number": "732-721-3763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.