Provider Demographics
NPI:1417241555
Name:UNITED SPECIALISTS PATHOLOGY LABORATORY INC
Entity type:Organization
Organization Name:UNITED SPECIALISTS PATHOLOGY LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:VINOVRSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-475-9140
Mailing Address - Street 1:3 WAKE ROBIN RD
Mailing Address - Street 2:UNIT 3B
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4208
Mailing Address - Country:US
Mailing Address - Phone:401-475-7308
Mailing Address - Fax:401-475-2808
Practice Address - Street 1:3 WAKE ROBIN RD
Practice Address - Street 2:UNIT 3B
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4208
Practice Address - Country:US
Practice Address - Phone:401-475-7308
Practice Address - Fax:401-475-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPENDING291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory