Healthcare Provider Details

I. General information

NPI: 1134191927
Provider Name (Legal Business Name): AMERIPATH NEW YORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E 32ND ST 10TH FLOOR
NEW YORK NY
10016-6055
US

IV. Provider business mailing address

14275 MIDWAY RD SUITE 400
ADDISON TX
75001-3614
US

V. Phone/Fax

Practice location:
  • Phone: 212-889-6225
  • Fax: 212-889-8268
Mailing address:
  • Phone: 214-932-8029
  • Fax: 610-271-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number33D0961556
License Number StateNY

VIII. Authorized Official

Name: KRISTIE M DOLAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 866-697-8378