Provider Demographics
NPI:1679158703
Name:NEW PATH MEDICAL LLC
Entity Type:Organization
Organization Name:NEW PATH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDINAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-298-5197
Mailing Address - Street 1:25 BAY STATE RD APT 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2108
Mailing Address - Country:US
Mailing Address - Phone:617-286-6518
Mailing Address - Fax:
Practice Address - Street 1:25 BAY STATE RD APT 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2108
Practice Address - Country:US
Practice Address - Phone:617-286-6518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty