Healthcare Provider Details
I. General information
NPI: 1659511509
Provider Name (Legal Business Name): SCHENECTADY PATHOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2009
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 NOTT ST
SCHENECTADY NY
12308-2425
US
IV. Provider business mailing address
PO BOX 1376
LATHAM NY
12110-8876
US
V. Phone/Fax
- Phone: 518-786-1298
- Fax: 518-786-1293
- Phone: 518-389-1803
- Fax: 518-389-1788
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:
BERNARD
NG
Title or Position: PRESIDENT
Credential: MD
Phone: 518-389-1803