Organization
MYGENOMEMYLIFEMGML
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPTI GUPTA (ADMINISTRATOR)
(513) 666-2440
Entity
Organization
Contact information
Practice address
1629 K ST NW STE 300NW, WASHINGTON, DC 20006-1602
(202) 476-0727
Mailing address
1629 K ST NW STE 300NW, WASHINGTON, DC 20006-1602
(202) 476-0727
Taxonomy
Speciality
Code
Description
License number
State
247000000X
Health Information Technician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
04/28/2021
Last updated
08/10/2021
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