Provider Demographics
NPI:1346256211
Name:MID-ATLANTIC PATHOLOGY SERVICES, PA
Entity Type:Organization
Organization Name:MID-ATLANTIC PATHOLOGY SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCHUYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-661-7280
Mailing Address - Street 1:535 E CRESCENT AVE
Mailing Address - Street 2:C/O HISTOPATHOLOGY SERVICES, LLC
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2922
Mailing Address - Country:US
Mailing Address - Phone:201-661-7280
Mailing Address - Fax:201-661-7297
Practice Address - Street 1:535 E CRESCENT AVE
Practice Address - Street 2:C/O HISTOPATHOLOGY SERVICES, LLC
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2922
Practice Address - Country:US
Practice Address - Phone:201-661-7280
Practice Address - Fax:201-661-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ085555TGNMedicare ID - Type Unspecified