Organization
CGC GENETICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. PURIFICACAO TAVARES M.D., PHD (CEO)
(973) 623-1264
Entity
Organization
Contact information
Practice address
185 S ORANGE AVE, F661, NEWARK, NJ 07103-2757
(973) 623-1264
(973) 623-1266
Mailing address
185 S ORANGE AVE, F661, NEWARK, NJ 07103-2757
(973) 623-1264
(973) 623-1266
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
COS00800249
CA
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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