Provider Demographics
NPI:1194051656
Name:ACCELPATH PATHOLOGY DIAGNOSTIC SERVICES PLLC
Entity type:Organization
Organization Name:ACCELPATH PATHOLOGY DIAGNOSTIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-401-0161
Mailing Address - Street 1:304 1/2 E 38TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2753
Mailing Address - Country:US
Mailing Address - Phone:347-401-0161
Mailing Address - Fax:
Practice Address - Street 1:304 1/2 E 38TH ST APT 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2753
Practice Address - Country:US
Practice Address - Phone:347-401-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202320-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty