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Organization

BOSTWICK LABORATORIES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN J STEFANELLI (CEO)
(516) 512-5200
Entity
Organization

Contact information

Practice address
6925 LAKE ELLENOR DR, SUITE 2, ORLANDO, FL 32809-4631
(407) 888-9937
(407) 856-0333
Mailing address
PO BOX 403751, ATLANTA, GA 30384-3751
(804) 967-9225
(804) 239-1954

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000265151
OH
05
003124823
CT
05
100003924
WI
05
1009021320005
PA
05
127455400
WY
01
138056
ANTHEM BCBS OF VIRGINIA
VA
05
1632939
LA
05
1871526384
AL
05
1871526384
IA
05
1871526384
UT
05
1871526384
VA
05
200024720C
OK
05
200931860A
IN
05
441761
AZ
05
68730055
NM
05
7001363
NC
05
7147838
WA
05
911980901
FL
05
93355076
CO
05
L00257
SC
Enumeration date
07/08/2006
Last updated
12/03/2014
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