Northeast Dermatopathology Institute

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

029481 Issued in PA

Legal business name

NORTHEAST DERMATOPATHOLOGY INSTITUTE

Practice address

405 S State St
Clarks Summit, PA 18411-1542

Phone

(570) 586-4400

Fax

(570) 587-5531

NPI assigned

Feb 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Brian Szymanski, M.D.NPI 1073585154

Title

Owner

Phone

(570) 586-4400

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 4

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

• Mark Brian Szymanski, M.D.

  • Dermatopathology (Pathology) Physician
  • Clarks Summit, PA
  • NPI 1073585154
  NPD (past) Authorized official
• Jeannie Hennessy, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hershey, PA
  • NPI 1104043561
  NPD (past)
• Michael Arthur Casey, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Puyallup, WA
  • NPI 1164782454
  NPD (past)
• Ian Mukand-Cerro, M.D.

  • Dermatopathology Physician
  • Bangor, ME
  • NPI 1316259435
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1477526655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111542",
            "telephone_number": "570-586-4400",
            "fax_number": "570-587-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111542",
            "telephone_number": "570-586-4400",
            "fax_number": "570-587-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DERMATOPATHOLOGY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "SZYMANSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-586-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "029481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00238091",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014008140001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebekah Ilene Nazarchuk, M.S.
• Anders P. Nelson, M.D.
• Robert L Nelson III, PT
• David Bengt Nesbit, M.D.
• Newton Ransom Volunteer Fire Company
• Northeast Imaging Consultants, PC
• Northern Tier Imaging Corp
• Caroline D Northup
• Michael Nunes
• James Patrick O'Hara, PHARMD

• Clinical Medical Laboratory in Clarks Summit, PA
• Providers in Clarks Summit, 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 Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.