Organization
PARK MADISON PROFESSIONAL LABORATORIES, INC.
Active
Other names
Park Madison Laboratories, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM DRESSLER (DIRECTOR)
(212) 628-7900
Entity
Organization
Contact information
Practice address
97 E 4TH ST, NEW YORK, NY 10003-9002
(212) 628-7900
(212) 628-7950
Mailing address
97 E 4TH ST, NEW YORK, NY 10003-9002
(212) 628-7900
(212) 628-7950
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
33D0130762
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00298384
—
NY
05
—
01469429
—
NY
05
—
02087061
—
NY
05
—
02166892
—
NY
01
—
33D0130762
CLIA CERTIFICATE
NY
Enumeration date
08/10/2006
Last updated
12/11/2012
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