Healthcare Provider Details

I. General information

NPI: 1548134158
Provider Name (Legal Business Name): SUPERB PATHOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 MAIN ST STE 2B
HACKENSACK NJ
07601-4802
US

IV. Provider business mailing address

810 MAIN ST STE 2B
HACKENSACK NJ
07601-4802
US

V. Phone/Fax

Practice location:
  • Phone: 551-209-0080
  • Fax:
Mailing address:
  • Phone: 551-209-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GORDANA KATAVA
Title or Position: PRESIDENT
Credential: DO
Phone: 551-209-0080