Provider Demographics
NPI:1902861958
Name:QUANTIPATH, INC
Entity Type:Organization
Organization Name:QUANTIPATH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANTINE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:AXIOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-683-1416
Mailing Address - Street 1:116 120 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3465
Mailing Address - Country:US
Mailing Address - Phone:212-683-1416
Mailing Address - Fax:
Practice Address - Street 1:116-120 E 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3465
Practice Address - Country:US
Practice Address - Phone:212-683-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLB6711Medicare PIN