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General NPI Number Information
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NPI Number | 1699175760
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Entity Type | Organization
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Legal Business Name | AMERIPATH NEW YORK, LLC
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 200 FOREST ST SUITE 3119
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City | MARLBOROUGH
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State | MA
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Zip | 01752-3023
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Country | US
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Telephone | 884-362-9801
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Fax | 774-843-3737
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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 | 844-362-9801
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Fax | 610-271-4245
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. EDWARD MICHAEL KRAMER
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Credential | MD
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Telephone | 610-550-3003
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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 |
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License Number State | MA
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