Basic Information
| Provider Information | |||||||||
| NPI: | 1225016140 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LABORATORIO DE PATOLOGIA DR NOY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 362842 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009362842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877511312 | ||||||||
| FaxNumber: | 7877515158 | ||||||||
| Practice Location | |||||||||
| Address1: | 239 ARTERIAL HOSTOS | ||||||||
| Address2: | SUITE 1-A SOTANO CAPITAL CENTER TORREL | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877511312 | ||||||||
| FaxNumber: | 7877560575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 10/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | NOY | ||||||||
| AuthorizedOfficialFirstName: | MIGUEL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRADOR | ||||||||
| AuthorizedOfficialTelephone: | 7877511312 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0101X | 264B | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
ID Information
| ID | Type | State | Issuer | Description | 2100371 | 01 | ACCA | OTHER | 611101 | 01 | HUMANA GOLD CHOICE | OTHER | 2659 | 01 | INTERNATIONAL MEDICAL CAR | OTHER | 069915 | 01 | LA CRUZ AZUL DE PR | OTHER | 800073 | 01 | MMM HEALTHCARE INC | OTHER | 9360108 | 01 | HUMANA INSURANCE COMPANY | OTHER | 0940699 | 01 | FONDO DEL SEGURO DEL ESTA | OTHER | 22685 | 01 | ASOCIACION DE MAESTROS DE | OTHER |