Healthcare Provider Details
I. General information
NPI: 1093790842
Provider Name (Legal Business Name): PARKVIEW PATHOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 MCCLELLAN ST
SCHENECTADY NY
12304-1009
US
IV. Provider business mailing address
PO BOX 624
LATHAM NY
12110-0624
US
V. Phone/Fax
- Phone: 518-382-5339
- Fax:
- Phone: 518-786-1299
- Fax: 518-786-1293
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DONALD
RICE
Title or Position: PRESIDENT
Credential: MD
Phone: 518-382-5339