Wantagh Diagnostic Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WANTAGH DIAGNOSTIC LAB INC

Practice address

1228 Wantagh Avenue
Suite Lli
Wantagh, NY 11793

Phone

(516) 221-0002

Fax

(516) 221-3241

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Maureen Donohue

Title

President Owner

Phone

(516) 221-0002

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972538593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 WANTAGH AVENUE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "11793",
            "telephone_number": "516-221-0002",
            "fax_number": "516-221-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 WANTAGH AVENUE",
            "address_2": "SUITE LLI",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "11793",
            "telephone_number": "516-221-0002",
            "fax_number": "516-221-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANTAGH DIAGNOSTIC LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONOHUE",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "516-221-0002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Waddell
• Debra Joan Wagner, MSED
• Kaitlyn Anne Wallner, LMSW
• Ning Wang, DAC
• Wantagh Dental Arts, PC
• Wantagh Family Orthodontics ,P.C.
• Wantagh Fire District
• Wantagh Internal Medicine, PC
• Wantagh Medical, P.C.
• Wantagh Pharmacy Inc

• Clinical Medical Laboratory in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Clinical Medical Laboratory in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.