Provider Demographics
NPI:1942601570
Name:QUANTUM PATHOLOGY, LLC
Entity Type:Organization
Organization Name:QUANTUM PATHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGUILIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-373-1689
Mailing Address - Street 1:318 BEAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1095
Mailing Address - Country:US
Mailing Address - Phone:781-373-1689
Mailing Address - Fax:781-373-2078
Practice Address - Street 1:318 BEAR HILL RD
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1095
Practice Address - Country:US
Practice Address - Phone:781-373-1689
Practice Address - Fax:781-373-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty