Provider Demographics
NPI:1962430900
Name:ROCHESTER PATHOLOGY PC
Entity type:Organization
Organization Name:ROCHESTER PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:KLIONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-652-5000
Mailing Address - Street 1:PO BOX 80275
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48308-0275
Mailing Address - Country:US
Mailing Address - Phone:248-652-5000
Mailing Address - Fax:248-652-5605
Practice Address - Street 1:1101 W UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1831
Practice Address - Country:US
Practice Address - Phone:248-652-5000
Practice Address - Fax:248-652-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty