Provider Demographics
NPI:1992798854
Name:VALLEY PATHOLOGISTS, INC.
Entity type:Organization
Organization Name:VALLEY PATHOLOGISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-224-9326
Mailing Address - Street 1:160 WYOMING STREET
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2740
Mailing Address - Country:US
Mailing Address - Phone:937-224-9326
Mailing Address - Fax:937-224-1010
Practice Address - Street 1:1 WYOMING STREET
Practice Address - Street 2:MIAMI VALLEY HOSPITAL PATHOLOGY DEPT
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-2978
Practice Address - Fax:937-208-6137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCI0037OtherRR MEDICARE
OH0572330Medicaid
OHCI0037OtherRR MEDICARE