Healthcare Provider Details
I. General information
NPI: 1104810308
Provider Name (Legal Business Name): MINKOWITZ PATHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
904 49TH ST
BROOKLYN NY
11219-2922
US
IV. Provider business mailing address
2810 AVENUE K
BROOKLYN NY
11210-3746
US
V. Phone/Fax
- Phone: 718-853-6433
- Fax: 718-853-6449
- Phone: 718-853-6433
- Fax: 718-853-6449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | 176318 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | 176318 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 176318 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | 176318 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
GERALD
MINKOWITZ
Title or Position: OWNER
Credential: M.D.
Phone: 718-853-6433