Iliad Neurosciences Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ILIAD NEUROSCIENCES INC.

Practice address

5110 Campus Dr Ste 190
Plymouth Meeting, PA 19462-1143

Phone

(610) 441-9050

NPI assigned

Oct 25, 2017

Organization subpart

No

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

Authorized official

Name

Brynn Martinez

Title

Credentialing Manager

Phone

(832) 434-8523

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1710499132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 CAMPUS DR STE 190",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621143",
            "telephone_number": "610-441-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 CAMPUS DR STE 190",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621143",
            "telephone_number": "610-441-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILIAD NEUROSCIENCES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "BRYNN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "832-434-8523"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Ickes, NURSE PRACTITIONER
• Patricia Iezzi
• Chukwuemeka Edmond Ihenachor I, RPH
• Fidelia Ikejiofor
• Elizabeth Ikiki, LPN
• Jennifer Illyes
• Ezinne Victoria Ilogu, PHARMD
• Nwadiogo Iloka, LPN
• Eseosa Imarhiaghe
• Mary Imel

• Clinical Medical Laboratory in Plymouth Meeting, PA
• Providers in Plymouth Meeting, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; 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.