Provider Demographics
NPI:1790784148
Name:ALBANY CYTOPATH LABS INC
Entity Type:Organization
Organization Name:ALBANY CYTOPATH LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-783-9189
Mailing Address - Street 1:15 OLD LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-5242
Mailing Address - Country:US
Mailing Address - Phone:518-783-9189
Mailing Address - Fax:518-783-9363
Practice Address - Street 1:15 OLD LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-5242
Practice Address - Country:US
Practice Address - Phone:518-783-9189
Practice Address - Fax:518-783-9363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000400201001OtherBNENY
NYL0773OtherEMPIRE BC
NY01478757Medicaid
NY01478757Medicaid