Provider Demographics
NPI:1194528430
Name:MANHATTAN PATH LAB, LLC
Entity type:Organization
Organization Name:MANHATTAN PATH LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ETHNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-777-9855
Mailing Address - Street 1:21 W END AVE APT 2007
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7976
Mailing Address - Country:US
Mailing Address - Phone:855-621-8250
Mailing Address - Fax:253-777-9855
Practice Address - Street 1:145 E 32ND ST GROUND FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6066
Practice Address - Country:US
Practice Address - Phone:855-621-8250
Practice Address - Fax:253-777-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory