Healthcare Provider Details
I. General information
NPI: 1750326161
Provider Name (Legal Business Name): HAMPSHIRE PATHOLOGISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 LOCUST ST
NORTHAMPTON MA
01060-2052
US
IV. Provider business mailing address
291 MOODY ST
LUDLOW MA
01056-1246
US
V. Phone/Fax
- Phone: 413-582-2175
- Fax: 413-582-2954
- Phone: 800-866-6663
- Fax: 413-589-7554
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
K
GLANTZ
Title or Position: PRESIDENT
Credential: MD
Phone: 413-584-4090