Organization
ST. ANTHONY MEDICAL LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH IBRAHIM MD (OWNER)
(201) 779-3320
Entity
Organization
Contact information
Practice address
654 AVENUE C, SUITE 303, BAYONNE, NJ 07002-3899
(201) 436-0033
(201) 436-0079
Mailing address
654 AVENUE C, SUITE 303, BAYONNE, NJ 07002-3899
(201) 436-0033
(201) 436-0079
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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