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General NPI Number Information
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NPI Number | 1538131362
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR DERMATOPATHOLOGY, INC.
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 3805 W CHESTER PIKE BLDG D, STE. 120
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2304
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Country | US
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Telephone | 610-260-0555
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Fax | 610-260-0566
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Provider Business Mailing Address
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Address Line | 14275 MIDWAY RD SUITE 400
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City | ADDISON
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State | TX
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Zip | 75001-3614
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Country | US
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Telephone |
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Fax | 610-271-4245
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRISTIE M DOLAN
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Credential |
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Telephone | 866-697-8378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 39D0698461
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License Number State | PA
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