Provider Demographics
NPI:1932339967
Name:INNOVATIVE PATHOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:INNOVATIVE PATHOLOGY SERVICES LLC
Other - Org Name:EMERGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCHUYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-342-7156
Mailing Address - Street 1:PO BOX 950
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-0950
Mailing Address - Country:US
Mailing Address - Phone:845-294-4339
Mailing Address - Fax:
Practice Address - Street 1:156 ROUTE 59
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-3627
Practice Address - Country:US
Practice Address - Phone:845-615-3319
Practice Address - Fax:845-294-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory