Organization
SHIEL MEDICAL LABORATORY, INC
Active
Organization
SHIEL MEDICAL LABORATORY, INC
Active
Other names
Shiel Medical Laboratory, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GITTY KOHN (ADMINISTRATIVE DIRECTOR)
(718) 552-1000
Entity
Organization
Contact information
Practice address
63 FLUSHING AVE, UNIT 336, BROOKLYN, NY 11205-1005
(718) 552-1000
(718) 875-5017
Mailing address
63 FLUSHING AVE, UNIT 336, BROOKLYN, NY 11205-1005
(718) 552-1000
(718) 875-5017
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
3709
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016539
GHI
NY
01
—
5127807
NJ MEDICAID #
NJ
Enumeration date
08/23/2005
Last updated
11/19/2007
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