Provider Demographics
NPI:1447061346
Name:NYS DIAGNOSTICS & SUPPLY
Entity type:Organization
Organization Name:NYS DIAGNOSTICS & SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINATA
Authorized Official - Middle Name:
Authorized Official - Last Name:SADDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-299-6339
Mailing Address - Street 1:13562 WATERFORD HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4654
Mailing Address - Country:US
Mailing Address - Phone:240-299-6339
Mailing Address - Fax:
Practice Address - Street 1:14816 PHYSICIANS LN STE 252
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3967
Practice Address - Country:US
Practice Address - Phone:443-430-0204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory