Provider Demographics
NPI:1104443688
Name:GENOMIC EXPRESSION INC.
Entity type:Organization
Organization Name:GENOMIC EXPRESSION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GITTE
Authorized Official - Middle Name:PEDERSEN
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:917-873-2003
Mailing Address - Street 1:100 CUMMINGS CTR STE 451C
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6132
Mailing Address - Country:US
Mailing Address - Phone:646-847-9290
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 451C
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6132
Practice Address - Country:US
Practice Address - Phone:646-847-9290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory