CRYOGEN PLUS LLC NPI 1790307924

NPI Information

NPI: 1790307924
Provider Name: CRYOGEN PLUS LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1039 GRANT ST SE BLDG A
ATLANTA, GA
ZIP 30315
Phone: (470) 428-2139
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CRYOGEN PLUS LLC is a multi-specialty clinic center in Atlanta, GA. CRYOGEN PLUS LLC NPI is 1790307924. The provider is registered as an organization entity type.

The provider's business location address is:

1039 GRANT ST SE BLDG A
ATLANTA, GA
ZIP 30315-014
Phone: (470) 428-2139

The provider's authorized official is Tynisha Astrel .
The authorized official title is Owner and has the following contact phone number (470) 428-2139.

The enumeration date for this NPI number is 5/11/2020 and was last updated on 5/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	20190026	OTHER	GEORGIA	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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