Provider Demographics
NPI:1477538486
Name:ADIRONDACK PATHOLOGY PC
Entity Type:Organization
Organization Name:ADIRONDACK PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PARANJPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-357-4829
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0761
Mailing Address - Country:US
Mailing Address - Phone:800-357-4829
Mailing Address - Fax:
Practice Address - Street 1:100 PARK ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4413
Practice Address - Country:US
Practice Address - Phone:518-926-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39254AMedicare ID - Type Unspecified