Healthcare Provider Details
I. General information
NPI: 1194795070
Provider Name (Legal Business Name): MARLBOROUGH HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/24/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
339 OLD HAYMAKER RD STE 1700 PARKWAY BLDG
MONROEVILLE PA
15146
US
IV. Provider business mailing address
339 OLD HAYMAKER RD STE 1700 PARKWAY BLDG
MONROEVILLE PA
15146
US
V. Phone/Fax
- Phone: 412-373-8300
- Fax: 412-373-7027
- Phone: 412-373-8300
- Fax: 412-373-7027
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | 800016595 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | 331 |
| License Number State | PA |
VIII. Authorized Official
Name:
ROBERT
H
SWEDARSKY
Title or Position: MEDICAL DIRECTOR SOLE MEMBER OF LLC
Credential: MD
Phone: 412-373-8300