Healthcare Provider Details
I. General information
NPI: 1811987456
Provider Name (Legal Business Name): NEW YORK UNIVERSITY MEDICAL CENTER PATHOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2005
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3301 QUANTUM BLVD
BOYNTON BEACH FL
33426-8668
US
IV. Provider business mailing address
550 1ST AVE 10 U
NEW YORK NY
10016-6402
US
V. Phone/Fax
- Phone: 877-648-2964
- Fax: 929-455-9477
- Phone: 212-263-5687
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZN0500X |
| Taxonomy | Neuropathology Physician |
| License Number | |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0101X |
| Taxonomy | Anatomic Pathology Physician |
| License Number | |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
T.
RUBIN
Title or Position: SR. ASST. DEAN OF CLINICAL AFFAIRS
Credential:
Phone: 212-263-2824