Provider Demographics
NPI:1275776452
Name:BIOPSY DIAGNOSTICS, PC
Entity Type:Organization
Organization Name:BIOPSY DIAGNOSTICS, PC
Other - Org Name:BIOPSY DIAGNOSTICS-NY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:F
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-379-2939
Mailing Address - Street 1:49 BROWNS COVE RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-8182
Mailing Address - Country:US
Mailing Address - Phone:843-379-2939
Mailing Address - Fax:843-379-2949
Practice Address - Street 1:64 SOUTHLAWN AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-3520
Practice Address - Country:US
Practice Address - Phone:917-518-1625
Practice Address - Fax:914-478-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory