Provider Demographics
NPI:1508855057
Name:PATHOLOGY ASSOCIATES OF NORWOOD PC
Entity Type:Organization
Organization Name:PATHOLOGY ASSOCIATES OF NORWOOD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:H
Authorized Official - Last Name:ADCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-278-6279
Mailing Address - Street 1:116 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4005
Mailing Address - Country:US
Mailing Address - Phone:781-278-6279
Mailing Address - Fax:781-551-0619
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:ATTN PATHOLOGY DEPT
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-769-4000
Practice Address - Fax:781-551-0619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9704621Medicaid
MAM17675OtherBCBS
MA687916OtherTUFTS
MAM20900Medicare PIN