Atlantic Dermatopathology, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

030360 Issued in PA

Legal business name

ATLANTIC DERMATOPATHOLOGY, LLC

Practice address

10 Industrial Highway
Airport Business Complex - Q3, Suite 1
Lester, PA 19029-1001

Phone

(610) 521-5040

Fax

(610) 521-5044

NPI assigned

Aug 24, 2007

Last updated

Feb 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Amelia M Zimmaro

Title

Business Manager

Phone

(610) 521-5040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• John K Mulholland, MD

  • Dermatology Physician
  • Bryn Mawr, PA
  • NPI 1912901802
  NPD (past)
• Robert Vincent Desilverio Jr., MD

  • Dermatology Physician
  • Linwood, NJ
  • NPI 1972591147
  NPD (past)

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1124211875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 523",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190060523",
            "telephone_number": "215-673-0423",
            "fax_number": "866-865-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 INDUSTRIAL HIGHWAY",
            "address_2": "AIRPORT BUSINESS COMPLEX - Q3, SUITE 1",
            "city": "LESTER",
            "state": "PA",
            "postal_code": "190291001",
            "telephone_number": "610-521-5040",
            "fax_number": "610-521-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC DERMATOPATHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "ZIMMARO",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "610-521-5040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "030360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Ashbridge-Balawejder, BCBA, LBS
• Evolutions ABA, LLC
• Lester Fire Company
• Maven Medical, LLC
• Willimina Teta Wordsworth VI

• Clinical Medical Laboratory in Lester, PA
• Providers in Lester, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.