Predictive Biosciences, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

2929 Issued in MA

Legal business name

PREDICTIVE BIOSCIENCES, INC.

Practice address

128 Spring St
400 Level, B Annex
Lexington, MA 02421-7848

Phone

(781) 402-1780

Fax

(781) 325-4939

NPI assigned

May 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Peter Klemm, PH.D.

Title

President & Chief Executive Officer

Phone

(781) 402-1780

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1669791901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 SPRING ST",
            "address_2": "400 LEVEL, B ANNEX",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024217848",
            "telephone_number": "781-402-1780",
            "fax_number": "781-325-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SPRING ST",
            "address_2": "400 LEVEL, B ANNEX",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024217848",
            "telephone_number": "781-402-1780",
            "fax_number": "781-325-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREDICTIVE BIOSCIENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "KLEMM",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "781-402-1780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "2929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID",
            "identifier": "22D1105541",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie M Power, PHD
• James Hilton Powers, MD
• Bill I Poznik, LICSW
• Chaitali Prabhu
• Rayne Jae Pratt, M.S. OTR/L
• Premise Health of Massachusetts, Medical PC (BAE Systems Lexington MA)
• Christina Marie Pretzie, MS, BCBA, LABA
• April Roots Prewitt, PH.D.
• Paulina Prieto Paz, PSYD
• Primewell Ventures Inc

• Clinical Medical Laboratory in Lexington, MA
• Providers in Lexington, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.