Provider Demographics
NPI:1932293214
Name:CENTRAL PATHOLOGY SERVICE PC
Entity Type:Organization
Organization Name:CENTRAL PATHOLOGY SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-542-1090
Mailing Address - Street 1:1900 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554
Mailing Address - Country:US
Mailing Address - Phone:516-542-1090
Mailing Address - Fax:516-794-8165
Practice Address - Street 1:355 BARD AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310
Practice Address - Country:US
Practice Address - Phone:718-818-3097
Practice Address - Fax:718-818-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty