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General NPI Number Information
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NPI Number | 1174587679
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Entity Type | Organization
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Legal Business Name | PATHWAYS PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 250 PLEASANT ST
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City | CONCORD
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State | NH
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Zip | 03301-7539
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Country | US
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Telephone | 603-225-2711
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 986520 DEPARTMENT 360
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City | BOSTON
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State | MA
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Zip | 02298-6520
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Country | US
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Telephone | 207-784-2554
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Fax | 207-777-1439
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TIMOTHY GORMAN
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Credential |
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Telephone | 603-225-2711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 34297
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License Number State | NH
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