NPIMap

Organization Active NPI

Trumbull Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Warren, OH
National Provider Identifier
1033174420
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
TRUMBULL PATHOLOGY ASSOCIATES
Practice address
1350 E Market St
Warren, OH 44483-6608
Phone
(330) 841-9346
Fax
(330) 841-9786
NPI assigned
Apr 19, 2006
Last updated
Apr 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert G Gurdak, MDNPI 1336116425
Title
President
Phone
(330) 841-9346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

1350 E Market St
Warren, OH 44483-6608

Mailing address

1350 E Market St
Warren, OH 44483-6608
Phone (330) 841-9346

Other identifiers 1

IdentifierTypeStateIssuer
0803554MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1033174420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836608",
            "telephone_number": "330-841-9346",
            "fax_number": "330-841-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836608",
            "telephone_number": "330-841-9346",
            "fax_number": "330-841-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUMBULL PATHOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "GURDAK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-841-9346",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803554",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.