Healthcare Provider Details

I. General information

NPI: 1740337286
Provider Name (Legal Business Name): PATHOLOGY ASSOCIATES OF LOWELL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 VARNUM AVENUE
LOWELL MA
01854-2134
US

IV. Provider business mailing address

5700 SOUTHWYCK BLVD
TOLEDO OH
43614-1509
US

V. Phone/Fax

Practice location:
  • Phone: 978-937-6341
  • Fax: 978-937-6085
Mailing address:
  • Phone: 800-288-8325
  • Fax: 419-866-5453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: LIJA JOSEPH
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 978-937-6341