Peconic Pathology Associates, PC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

PECONIC PATHOLOGY ASSOCIATES, PC

Practice address

1300 Roanoke Avenue
Riverhead, NY 11901-2058

Phone

(800) 326-6222

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Ranjana Mathur, MD

Title

President

Phone

(800) 326-6222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1265523708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HEMPSTEAD TPKE",
            "address_2": "SUITE 500",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541724",
            "telephone_number": "516-542-1090",
            "fax_number": "516-794-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ROANOKE AVENUE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012058",
            "telephone_number": "800-326-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECONIC PATHOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "MATHUR",
        "authorized_official_first_name": "RANJANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-326-6222",
        "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": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Anatomic Pathology & Clinical Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.