Provider Demographics
NPI:1952382160
Name:PATHOLOGY SPECIALISTS PC
Entity Type:Organization
Organization Name:PATHOLOGY SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROHINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-427-3086
Mailing Address - Street 1:460 TOTTEN POND RD
Mailing Address - Street 2:C O MZI
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1906
Mailing Address - Country:US
Mailing Address - Phone:781-890-9933
Mailing Address - Fax:781-890-9950
Practice Address - Street 1:235 N PEARL ST
Practice Address - Street 2:ATTN PATHOLOGY DEPT
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1794
Practice Address - Country:US
Practice Address - Phone:508-427-3086
Practice Address - Fax:508-588-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42354207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA732320OtherTUFTS
MA9772804Medicaid
MAM15909OtherBCBS
MA732320OtherTUFTS