Provider Demographics
NPI:1336113422
Name:WHITE PLAINS PATHOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:WHITE PLAINS PATHOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-562-7995
Mailing Address - Street 1:PO BOX 4264
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-0264
Mailing Address - Country:US
Mailing Address - Phone:845-562-7995
Mailing Address - Fax:
Practice Address - Street 1:DAVIS AVE AT E POST RD
Practice Address - Street 2:WHITE PLAINS PATHOLOGY ASSOCIATES PC
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4615
Practice Address - Country:US
Practice Address - Phone:845-562-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W19571Medicare PIN