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General NPI Number Information
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NPI Number | 1558276675
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Entity Type | Organization
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Legal Business Name | PILGRIM MEDICAL CENTER LAB
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 393 BLOOMFIELD AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3741
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Country | US
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Telephone | 973-746-8181
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Fax | 973-746-0937
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Provider Business Mailing Address
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Address Line | 393 BLOOMFIELD AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3741
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Country | US
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Telephone | 973-746-8181
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Fax | 973-746-0937
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Authorized Official
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Title or Position | CFO/ ADMINISTRATOR
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Name | MRS. ELLE KOTOPOULOS
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Credential |
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Telephone | 973-746-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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