1346300738 NPI number — THE PATHOLOGY ASSOCIATES, P.A.

Table of content: (NPI 1346300738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346300738 NPI number — THE PATHOLOGY ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE PATHOLOGY ASSOCIATES, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346300738
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 66
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12201-0066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-806-4271
Provider Business Mailing Address Fax Number:
207-777-1439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 MEDICAL CENTER PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04330-8160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-626-1409
Provider Business Practice Location Address Fax Number:
207-626-1046
Provider Enumeration Date:
12/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AUBERTINE
Authorized Official First Name:
CHERI
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
207-629-7162

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1044151 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 176211 . This is a "TUFTS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: H0072 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: M55180 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1044151 . This is a "AETNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 152669 . This is a "UNIVERSAL HEALTHCARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 134630078 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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