MEDICARE: REGIONAL PATHOLOGY ASSOCIATES, PC

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

General Provider Information

NPI Number	:	1336531037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL PATHOLOGY ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	529 CENTRAL AVE
Second Line	:
City	:	DUNKIRK
State	:	NY
Zip	:	14048-2514
Country	:	US
Telephone Number	:	716-366-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 SOUTHWYCK BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-1509
Country	:	US
Telephone Number	:	800-288-8325
Fax Number	:	419-866-5453

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER DEPOWSKI
Credential	:	MD
Telephone Number	:	716-366-1111

Provider Enumeration Date	:	03/04/2015
Last Update Date	:	03/04/2015

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