Provider Demographics
NPI:1811987456
Name:NEW YORK UNIVERSITY MEDICAL CENTER PATHOLOGY ASSOCIATES
Entity type:Organization
Organization Name:NEW YORK UNIVERSITY MEDICAL CENTER PATHOLOGY ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. ASST. DEAN OF CLINICAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-263-2824
Mailing Address - Street 1:550 1ST AVE
Mailing Address - Street 2:10 U
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-5687
Mailing Address - Fax:
Practice Address - Street 1:3301 QUANTUM BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8668
Practice Address - Country:US
Practice Address - Phone:877-648-2964
Practice Address - Fax:929-455-9477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-25
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207ZC0500X, 207ZN0500X, 207ZP0101X
207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Multi-Specialty
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathologyGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW21961Medicare PIN