Provider Demographics
NPI:1750326161
Name:HAMPSHIRE PATHOLOGISTS, INC.
Entity Type:Organization
Organization Name:HAMPSHIRE PATHOLOGISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GLANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-584-4090
Mailing Address - Street 1:291 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1246
Mailing Address - Country:US
Mailing Address - Phone:800-866-6663
Mailing Address - Fax:413-589-7554
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2175
Practice Address - Fax:413-582-2954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT50000PMS19OtherCT BLUE SHIELD
MA0008668OtherNEIGHBOORHOOD
MAM13829OtherBCBS MA
MA0463289OtherAETNA
MAS006844OtherCHAMPVA/TRICARE-CHAMPUS
MA9734244Medicaid
NYW40841OtherNY BLUE SHIELD
M13829Medicare ID - Type Unspecified