MEDICARE: ROCHESTER PATHOLOGY 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number	:	1962430900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCHESTER PATHOLOGY PC

Provider Business Mailing Address
First Line	:	PO BOX 80275
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48308-0275
Country	:	US
Telephone Number	:	248-652-5000
Fax Number	:	248-652-5605

Provider Business Practice Location Address
First Line	:	1101 W UNIVERSITY DRIVE
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48307-1831
Country	:	US
Telephone Number	:	248-652-5000
Fax Number	:	248-652-5605

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID L KLIONSKY
Credential	:	MD
Telephone Number	:	248-652-5000

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/22/2020

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Directions to “ROCHESTER PATHOLOGY PC ” Practice Location

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