Organization
FASTRAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN BERG (COO)
(732) 905-1008
Entity
Organization
Contact information
Practice address
101 N 3RD ST, BROOKLYN, NY 11211-3943
(718) 594-1001
(718) 594-1006
Mailing address
101 N 3RD ST, BROOKLYN, NY 11211-3943
(718) 594-1001
(718) 594-1006
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
A300000608
NY
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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