Provider Demographics
NPI:1215921549
Name:ACUPATH LABORATORIES, INC.
Entity type:Organization
Organization Name:ACUPATH LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:516-775-8103
Mailing Address - Street 1:28 S TERMINAL DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2311
Mailing Address - Country:US
Mailing Address - Phone:516-394-5594
Mailing Address - Fax:
Practice Address - Street 1:28 S TERMINAL DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2309
Practice Address - Country:US
Practice Address - Phone:516-775-8103
Practice Address - Fax:516-326-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33D0912240291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0898261Medicaid
PA103825180-0001Medicaid
AZ121508Medicaid
NV250022490Medicaid
GA328502984AMedicaid
NYL26201OtherEMPIRE BCBS
NY02067747Medicaid
TNQ080354Medicaid