Gladzim Medical Laboratories Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLIA ID 33D1034578 Issued in MD

Legal business name

GLADZIM MEDICAL LABORATORIES INC.

Practice address

108 S Munn Ave
East Orange, NJ 07018-3402

Phone

(973) 619-2622

Fax

(973) 677-1181

NPI assigned

Oct 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gladys Ngozi Ibezim, PH.D

Title

President & Director

Phone

(973) 619-2622

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1224979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1700039435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 FRANKLIN ST",
            "address_2": "UNIT #3",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034978",
            "telephone_number": "973-619-2622",
            "fax_number": "973-677-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S MUNN AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070183402",
            "telephone_number": "973-619-2622",
            "fax_number": "973-677-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADZIM MEDICAL LABORATORIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-26",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "IBEZIM",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_middle_name": "NGOZI",
        "authorized_official_title_or_position": "PRESIDENT  &  DIRECTOR",
        "authorized_official_telephone_number": "973-619-2622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "CLIA ID 33D1034578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in East Orange, NJ
• Providers in East Orange, 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 Feb 13, 2009; 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.