Provider Demographics
NPI:1063474724
Name:LATULIPPE PATHOLOGY P A
Entity Type:Organization
Organization Name:LATULIPPE PATHOLOGY P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LATULIPPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-385-7200
Mailing Address - Street 1:PO BOX 5254
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-0254
Mailing Address - Country:US
Mailing Address - Phone:330-520-2221
Mailing Address - Fax:330-776-5557
Practice Address - Street 1:425 W 5TH STREET
Practice Address - Street 2:
Practice Address - City:E LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920
Practice Address - Country:US
Practice Address - Phone:330-385-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077781207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2187682Medicaid
OH2187682Medicaid
H26320Medicare UPIN