Organization
FASTRAD PENNSYLVANIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN WEXLER (MEMBER)
(718) 594-1001
Entity
Organization
Contact information
Practice address
101 N 3RD ST, BROOKLYN, NY 11211-3943
(718) 594-1001
Mailing address
101 N 3RD ST, BROOKLYN, NY 11211-3943
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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