Organization · NPI-2
675 Delaware LLC
Physiological Laboratory · Lake View, NY
NPI number1346570827
StatusActive
Last updated in NPPESJan 6, 2010
Details
- NPI
- 1346570827
- Entity type
- Organization (NPI-2)
- Legal business name
- 675 Delaware LLC
- Organization subpart
- No
- Enumeration date
- Jan 6, 2010
- Last updated
- Jan 6, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 293D00000X | Physiological Laboratory | – | – | Yes |
Practice location
6364 White Oak WayLake View, NY 14085-9572
Phone 716-997-9410
Mailing address
6364 White Oak WayLake View, NY 14085-9572
Phone 716-997-9410
Authorized official
Todd Cross
Managing Partner
7169979410
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