Basic Information
| Provider Information | |||||||||
| NPI: | 1235184854 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HASSAN NAMDARI | ||||||||
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| OtherOrganizationName: | CLIN-MICRO IMMUNOLOGY CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 ABINGTON EXECUTIVE PARK | ||||||||
| Address2: | SUITE C | ||||||||
| City: | CLARKS SUMMIT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184112258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707028130 | ||||||||
| FaxNumber: | 5707028131 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 ABINGTON EXECUTIVE PARK | ||||||||
| Address2: | SUITE C | ||||||||
| City: | CLARKS SUMMIT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184112258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707028130 | ||||||||
| FaxNumber: | 5707028131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 02/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | NAMDARI | ||||||||
| AuthorizedOfficialFirstName: | HASSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/CEO | ||||||||
| AuthorizedOfficialTelephone: | 5709417818 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 029744 | PA | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.