Organization
NORTHEASTERN REPRODUCTIVE MEDICINE LABORATORIES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER R. CASSON MD (AUTHORIZED REP/OWNER)
(802) 655-8888
Entity
Organization
Contact information
Practice address
105 WESTVIEW RD, SUITE 302, COLCHESTER, VT 05446-8025
(802) 655-8888
(802) 985-2566
Mailing address
105 WESTVIEW RD, SUITE 302, COLCHESTER, VT 05446-8025
(802) 655-8888
(802) 985-2566
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
47D2079212
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023974
—
VT
Enumeration date
08/29/2014
Last updated
03/02/2015
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