Mountain Lakes Pathology LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MOUNTAIN LAKES PATHOLOGY LLC

Practice address

115 Route 46 W
Suite B-12
Mountain Lakes, NJ 07046-1668

Phone

(973) 809-7706

NPI assigned

Jul 28, 2011

Last updated

Jul 28, 2011By 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

Dr. Essam Ahmed, MDNPI 1710969886

Title

Principal Owner

Phone

(973) 831-5046

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Essam A. Ahmed, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pompton Plains, NJ
  • NPI 1710969886
  NPD Authorized official
• Lan Wang, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pompton Plains, NJ
  • NPI 1306828447
  NPD

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1316225097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROUTE 46 W",
            "address_2": "SUITE B-12",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461668",
            "telephone_number": "973-809-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROUTE 46 W",
            "address_2": "SUITE B-12",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461668",
            "telephone_number": "973-809-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAKES PATHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "ESSAM",
        "authorized_official_title_or_position": "PRINCIPAL OWNER",
        "authorized_official_telephone_number": "973-831-5046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8065301",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8606005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Mooney, PHD, LPC
• Morris Speech Therapy Associates, LLC
• Mountain Lakes Family Practice LLC
• Mountain Lakes Integrated Healthcare
• Mountain Lakes Medical Center, LLC
• Mountain Lakes Premier Dental , LLC
• Mountain Lakes Psychotherapy, LLC
• Mpower Physical Therapy LLC
• MTB First Assist LLC
• Sheikh Marie Naeem, MD

• Clinical Medical Laboratory in Mountain Lakes, NJ
• Providers in Mountain Lakes, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.