MEDICARE: AMERIPATH NEW YORK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	33D0687350	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	L84881	OTHER	NY	BCBS

General Provider Information

NPI Number	:	1043282841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERIPATH NEW YORK LLC

Provider Business Mailing Address
First Line	:	14275 MIDWAY RD
Second Line	:	SUITE 400
City	:	ADDISON
State	:	TX
Zip	:	75001-3614
Country	:	US
Telephone Number	:
Fax Number	:	610-271-4245

Provider Business Practice Location Address
First Line	:	1133 WESTCHESTER AVE STE 331
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-3516
Country	:	US
Telephone Number	:	914-996-1525
Fax Number	:	800-942-3376

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DARREN THOMAS WHEELER
Credential	:
Telephone Number	:	702-733-7866

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	09/05/2024

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Directions to “AMERIPATH NEW YORK LLC ” Practice Location

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