NPIMap

Organization Active NPI

Northeast Critical Care Clinical Labs

  • Clinical Medical Laboratory
  • Tamaqua, PA
National Provider Identifier
1942949177
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NORTHEAST CRITICAL CARE CLINICAL LABS
Practice address
229 W Broad Street
Tamaqua, PA 18252
Phone
(570) 657-1634
Fax
(570) 645-3397
NPI assigned
Jun 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Authorized official

Name
Mr. David B. Kasprzak, CRNPNPI 1043654197
Title
Ceo
Phone
(570) 657-1634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

229 W Broad Street
Tamaqua, PA 18252

Mailing address

229 W Broad Street
Tamaqua, PA 18252
Phone (570) 657-1634

Other names 1

  • NCC Clinical Labs Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Critical Care LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654300800000",
    "number": "1942949177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W BROAD STREET",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "18252",
            "telephone_number": "570-657-1634",
            "fax_number": "570-645-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W BROAD STREET",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "18252",
            "telephone_number": "570-657-1634",
            "fax_number": "570-645-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CRITICAL CARE CLINICAL LABS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-04",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A",
        "authorized_official_last_name": "KASPRZAK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-657-1634",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCC Clinical Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tamaqua, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; 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.