Provider Demographics
NPI:1508866468
Name:LANGHORNE PATHOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:LANGHORNE PATHOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:IGDE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:215-710-2162
Mailing Address - Street 1:111 CONTINENTAL DRIVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:888-625-4685
Mailing Address - Fax:302-731-2496
Practice Address - Street 1:1201 LANGHORNE- NEWTOWN ROAD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-710-2162
Practice Address - Fax:215-710-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017551370003Medicaid
PA0017551370003Medicaid