Provider Demographics
NPI:1407956386
Name:UNIVERSITY PATHOLOGY, P.C.
Entity Type:Organization
Organization Name:UNIVERSITY PATHOLOGY, P.C.
Other - Org Name:UNIVERSITY PATHOLOGY @DOBBS FERRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:MELAMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-393-6393
Mailing Address - Street 1:1 WESTCHESTER PLZ
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-1600
Mailing Address - Country:US
Mailing Address - Phone:914-307-1678
Mailing Address - Fax:914-345-3064
Practice Address - Street 1:128 ASHFORD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1924
Practice Address - Country:US
Practice Address - Phone:914-559-1024
Practice Address - Fax:914-674-9118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY PATHOLOGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W23043Medicare PIN