Healthcare Provider Details
I. General information
NPI: 1194830471
Provider Name (Legal Business Name): MOUNT AUBURN PATHOLOGISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2006
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
330 MOUNT AUBURN ST
CAMBRIDGE MA
02138-5502
US
IV. Provider business mailing address
330 MOUNT AUBURN ST
CAMBRIDGE MA
02138-5502
US
V. Phone/Fax
- Phone: 617-965-2000
- Fax:
- Phone: 800-927-0002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRINDA
KAMAT
Title or Position: PRESIDENT
Credential: MD
Phone: 617-965-2000