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SKIN PATHOLOGY LABORATORY INC. NPI 1073648069


NPI Information

NPI: 1073648069
Provider Name: SKIN PATHOLOGY LABORATORY, INC.
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 22D0075241

Address:
609 ALBANY ST FL 3
BOSTON, MA
ZIP 02118
Phone: (617) 638-5570
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SKIN PATHOLOGY LABORATORY, INC. is a dermatopathology dermatology in Boston, MA. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. SKIN PATHOLOGY LABORATORY, INC. NPI is 1073648069. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

609 ALBANY ST FL 3
BOSTON, MA
ZIP 02118-515
Phone: (617) 638-5570
Fax: (617) 638-5575

The provider's authorized official is Jag Bhawan .
The authorized official title is President and has the following contact phone number (617) 638-5570.

The CLIA number assigned to this NPI record is 22D0075241 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0900XDermatologyDermatopathologyMASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19750878MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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