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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