Basic Information
| Provider Information | |||||||||
| NPI: | 1700217940 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHORE PATHOLOGY ASSOCIATES P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 E NEW YORK AVE | ||||||||
| Address2: | |||||||||
| City: | SOMERS POINT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082442340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096533500 | ||||||||
| FaxNumber: | 6099264311 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 E NEW YORK AVE | ||||||||
| Address2: | |||||||||
| City: | SOMERS POINT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082442340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096533500 | ||||||||
| FaxNumber: | 6099264311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2013 | ||||||||
| LastUpdateDate: | 12/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | SPARAGNA | ||||||||
| AuthorizedOfficialFirstName: | ANGELO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6093656200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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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 |
No ID Information.