Provider Demographics
NPI:1215980610
Name:CANCER GENETICS INC.
Entity type:Organization
Organization Name:CANCER GENETICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-528-9200
Mailing Address - Street 1:201 ROUTE 17 NORTH
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-528-9200
Mailing Address - Fax:201-528-9201
Practice Address - Street 1:201 ROUTE 17 NORTH
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-263-1323
Practice Address - Fax:201-263-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31D1038733291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096908Medicare ID - Type Unspecified
096908Medicare UPIN