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MODERN DIAGNOSTIC LABORATORY INC NPI 1720084551


NPI Information

NPI: 1720084551
Provider Name: MODERN DIAGNOSTIC LABORATORY, INC
Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization
Address:
1412 BAY RIDGE AVE
BROOKLYN, NY
ZIP 11219
Phone: (718) 837-5222
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MODERN DIAGNOSTIC LABORATORY, INC is a clinical medical laboratory in Brooklyn, NY. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. MODERN DIAGNOSTIC LABORATORY, INC NPI is 1720084551. The provider is registered as an organization entity type.

The provider's business location address is:

1412 BAY RIDGE AVE
BROOKLYN, NY
ZIP 11219-231
Phone: (718) 837-5222
Fax: (718) 259-0088

The provider's authorized official is Aron Tessler .
The authorized official title is Treasurer and has the following contact phone number (718) 837-5222.

The enumeration date for this NPI number is 6/27/2005 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical LaboratoryPFI: 3848NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHEROXFORD
20823708MEDICAIDNEW JERSEY
301064002MEDICAIDNEW YORK
4L062010OTHERNEW YORKEMPIRE BC/BS
5L062010MEDICARE ID-TYPE UNSPECIFIEDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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