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General NPI Number Information
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NPI Number | 1306827712
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Entity Type | Organization
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Legal Business Name | POMPTON PLAINS PATHOLOGISTS P A
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 97 W PARKWAY DEPT. OF PATHOLOGY
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1647
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Country | US
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Telephone | 973-831-5046
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Fax | 973-831-5194
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Provider Business Mailing Address
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Address Line | PO BOX 144333
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City | ORLANDO
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State | FL
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Zip | 32814-4333
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Country | US
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Telephone | 407-422-9831
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Fax | 407-648-2065
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Authorized Official
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Title or Position | PRESIDENT
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Name | ESSAM A. AHMED
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Credential | M.D.
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Telephone | 973-831-5046
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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 |
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License Number State |
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