Organization Active NPI

Pathology at Jeanes

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1265495923
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGY AT JEANES
Practice address
7600 Central Avenue
Philadelphia, PA 19111
Phone
(215) 728-2040
Fax
(215) 728-2064
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Authorized official

Name
Dr. Andrew Czulewicz, MD
Title
Chairman
Phone
(215) 728-2040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

7600 Central Avenue
Philadelphia, PA 19111

Mailing address

7600 Central Avenue
Philadelphia, PA 19111
Phone (215) 728-2040

Other identifiers 1

IdentifierTypeStateIssuer
1010060310001MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1265495923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 CENTRAL AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-2040",
            "fax_number": "215-728-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CENTRAL AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-2040",
            "fax_number": "215-728-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY AT JEANES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "CZULEWICZ",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "215-728-2040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010060310001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.