Healthcare Provider Details

I. General information

NPI: 1578660833
Provider Name (Legal Business Name): THE PATHOLOGY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BEEKMAN STREET
PLATTSBURGH NY
12901
US

IV. Provider business mailing address

PO BOX 2828
PLATTSBURGH NY
12901
US

V. Phone/Fax

Practice location:
  • Phone: 518-561-6323
  • Fax: 518-561-6325
Mailing address:
  • Phone: 518-561-6323
  • Fax: 518-561-6325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DEONARAYAN P SAHA
Title or Position: SECRETARY TREASURER
Credential: MD
Phone: 518-561-6323