Organization
LIBRA SUITES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANN SMALL (OWNER)
(917) 383-5753
Entity
Organization
Contact information
Practice address
460 E FORDHAM RD # 2032, BRONX, NY 10458-5108
(347) 780-4853
Mailing address
460 E FORDHAM RD # 2032, BRONX, NY 10458-5108
(347) 780-4853
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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