Provider Demographics
NPI:1740251578
Name:LABORATORY MEDICINE ASSOCIATES, LLP
Entity type:Organization
Organization Name:LABORATORY MEDICINE ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-348-2270
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:160 N. MIDLAND AVE. FL1
Practice Address - Street 2:NYACK HOSPITAL PATHOLOGY DEPT
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1912
Practice Address - Country:US
Practice Address - Phone:845-348-2270
Practice Address - Fax:845-348-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCI9148OtherRR MCR
NYWLC501Medicare PIN