Provider Demographics
NPI:1487126397
Name:KINGS DIAGNOSTICS INC
Entity type:Organization
Organization Name:KINGS DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEVCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-204-4460
Mailing Address - Street 1:10 CLINTON ST APT 8R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2327 83RD ST STE D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2749
Practice Address - Country:US
Practice Address - Phone:347-922-5970
Practice Address - Fax:347-657-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty