Provider Demographics
NPI:1669870705
Name:DAHL CHASE PATHOLOGY ASSOC.
Entity type:Organization
Organization Name:DAHL CHASE PATHOLOGY ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER ACCOUNTS REC.
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PASTERNACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-941-8270
Mailing Address - Street 1:417 STATE ST
Mailing Address - Street 2:SUITE 439
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6630
Mailing Address - Country:US
Mailing Address - Phone:207-941-8200
Mailing Address - Fax:207-990-4848
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:SUITE 439
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-941-8200
Practice Address - Fax:207-990-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME105060000Medicaid
ME105060000Medicaid
MECK1230Medicare PIN