Ameripath New York LLC
Organization Active NPI Clinical Medical Laboratory · Shelton, CT
NPI 1194797993 · NPPES record last updated Sep 5, 2024
Key facts
- NPI
- 1194797993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 07D1035411 (NY)
- Legal business name
- AMERIPATH NEW YORK LLC
- Practice address
- 1 Greenwich PL
Shelton, CT 06484-4618 - Phone
- (866) 436-9631
- Fax
- (203) 447-8666
- NPI assigned
- Feb 6, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- AMERIPATH INC.
Authorized official
- Name
- Darren Thomas Wheeler
- Title
- Vice President
- Phone
- (702) 733-7866
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 5
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050511000568 | CT | Part B Supplier - Independent Clinical Laboratory | 9133015688 | Practice locations: Shelton, CT |
National Provider Directory
- Tax ID family
- Ameripath New York LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 07D1035411 | NY | Yes |
Addresses
Primary practice location
1 Greenwich PL
Shelton, CT 06484-4618
Mailing address
14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (214) 932-8029
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004250130 | Medicaid | CT | |
| 2643769 | Medicaid | OH | |
| 100771649003 | Medicaid | PA | |
| 200279840A | Medicaid | OK | |
| 22339752 | Medicaid | CO | |
| 0093254 | Medicaid | NJ | |
| 015532634A | Medicaid | GA | |
| 176325201 | Medicaid | TX | |
| 412163500 | Medicaid | MD | |
| L00237 | Medicaid | SC | |
| 3810005215 | Medicaid | WV | |
| 7001262 | Medicaid | NC |
Other names
- AmeriPath Northeast
Other providers in Shelton, CT
- Deborah Ruth Alter
- Jason Michael Altman
- Suzana Alvarez
- Ashley Amarante
- Amber Horizon Longterm Care PC
- Reshma Amin
- Anchor Health Care
- Ancillary-X LLC
- Emmanuela N/a Andreus
- Yvonne Andrews
All providers in Shelton, CT · Clinical Medical Laboratory in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.