Immunogen Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IMMUNOGEN DIAGNOSTICS, LLC

Practice address

50 Fairfield Rd
Fairfield, NJ 07004-2414

Phone

(973) 808-5550

Fax

(973) 808-5999

NPI assigned

Mar 26, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Neel Bose

Title

President

Phone

(973) 808-1429

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1700100211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 FAIRFIELD RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042414",
            "telephone_number": "973-808-5550",
            "fax_number": "973-808-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FAIRFIELD RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042414",
            "telephone_number": "973-808-5550",
            "fax_number": "973-808-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNOGEN DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "BOSE",
        "authorized_official_first_name": "NEEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-808-1429",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "31D1107857",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniella Howell, APRN
• Glen Roy Howell, RPH
• Human Institute LLC
• Muhammad Azeem Iftikhar
• Filomena Ilaria, ARNP
• Amanda Lee Ivos, DNP, FNP-BC
• Ankur Jetley
• Asja Johnson
• Rohit Jolly, PHARMD
• Joseph B Liotti

• Clinical Medical Laboratory in Fairfield, NJ
• Providers in Fairfield, 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 Apr 14, 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.