Provider Demographics
NPI:1770648255
Name:HIGH PEAKS PATHOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:HIGH PEAKS PATHOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-897-2379
Mailing Address - Street 1:147 FIR WAY
Mailing Address - Street 2:UNIT 27
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-3464
Mailing Address - Country:US
Mailing Address - Phone:518-523-8903
Mailing Address - Fax:316-221-8166
Practice Address - Street 1:2233 STATE ROUTE 86
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-0471
Practice Address - Country:US
Practice Address - Phone:518-897-2379
Practice Address - Fax:518-897-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF18097Medicare UPIN
NY56146AMedicare PIN