Provider Demographics
NPI:1770966301
Name:COMPENDIUM PATHOLOGY PC
Entity type:Organization
Organization Name:COMPENDIUM PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:CANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-370-1886
Mailing Address - Street 1:524 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1913
Mailing Address - Country:US
Mailing Address - Phone:610-828-7100
Mailing Address - Fax:610-828-1360
Practice Address - Street 1:524 E ELM ST
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1913
Practice Address - Country:US
Practice Address - Phone:610-828-7100
Practice Address - Fax:610-828-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory