Basic Information
| Provider Information | |||||||||
| NPI: | 1053355248 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORANGE PATHOLOGY ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911 | ||||||||
| Address2: | |||||||||
| City: | RAMSEY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074460911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016617280 | ||||||||
| FaxNumber: | 2016617297 | ||||||||
| Practice Location | |||||||||
| Address1: | 156 ROUTE 59 | ||||||||
| Address2: | SUITE B4 | ||||||||
| City: | SUFFERN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109015005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453694200 | ||||||||
| FaxNumber: | 2016617297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 04/22/2013 | ||||||||
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| AuthorizedOfficialLastName: | NEWMAN | ||||||||
| AuthorizedOfficialFirstName: | SCHUYLER | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2016617280 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | CB3197 | 01 | NY | RAILROAD MEDICARE | OTHER |