Provider Demographics
NPI:1699968974
Name:GREENWICH PATHOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:GREENWICH PATHOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, GPA, LLC
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALTMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-863-3065
Mailing Address - Street 1:5 PERRYRIDGE RD
Mailing Address - Street 2:PATHOLOGY DEPT
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4608
Mailing Address - Country:US
Mailing Address - Phone:203-863-3065
Mailing Address - Fax:203-863-3846
Practice Address - Street 1:5 PERRYRIDGE RD
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4608
Practice Address - Country:US
Practice Address - Phone:203-863-3065
Practice Address - Fax:203-863-3846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical MicrobiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT07D0101367OtherCLIA