Provider Demographics
NPI:1104950468
Name:PATHOLOGY ASSOCIATES, INC
Entity type:Organization
Organization Name:PATHOLOGY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:KWASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-469-5404
Mailing Address - Street 1:1 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-469-5404
Mailing Address - Fax:978-469-5378
Practice Address - Street 1:1 PARK WAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-469-5404
Practice Address - Fax:978-469-5378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
36113OtherCIGNA
42465044OtherCHAMPUS
MA800005OtherTAHP
MA9700927Medicaid
MA2011716OtherUS HEALTHCARE
800005OtherTUFTS
NH30004064Medicaid
M10760OtherBLUE SHIELD MA
2011716OtherAETNA/US HEALTH
974157OtherNETWORK HEALTH
36113OtherCIGNA