Basic Information
| Provider Information | |||||||||
| NPI: | 1477538486 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADIRONDACK PATHOLOGY PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 761 | ||||||||
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| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121100761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003574829 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 PARK ST | ||||||||
| Address2: | |||||||||
| City: | GLENS FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128014413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5189263838 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2005 | ||||||||
| LastUpdateDate: | 02/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | PARANJPE | ||||||||
| AuthorizedOfficialFirstName: | JAYANT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8003574829 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.