Healthcare Provider Details

I. General information

NPI: 1922075886
Provider Name (Legal Business Name): MORRISTOWN PATHOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 05/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

P.O. BOX 500
HACKETTSTOWN NJ
07840-0500
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5612
  • Fax: 973-290-7370
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number25MF00056400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JORY G MAGIDSON
Title or Position: PRESIDENT
Credential:
Phone: 973-971-5612