NPIMap

Organization Active NPI

Pathology Associates of Central Jersey Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Perth Amboy, NJ
National Provider Identifier
1619287398
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MA67626 Issued in NJ
Legal business name
PATHOLOGY ASSOCIATES OF CENTRAL JERSEY INC.
Practice address
530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone
(732) 324-5171
Fax
(732) 324-4999
NPI assigned
Oct 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Authorized official

Name
Dr. Stacey Lee Longo, M.D.
Title
President
Phone
(732) 324-5171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X MA67626 NJ Primary

Addresses

Primary practice location

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654

Mailing address

PO Box 736
Holmdel, NJ 07733-0736
Phone (732) 324-5171

Other identifiers 3

IdentifierTypeStateIssuer
8069204MedicaidNJ
02909108MedicaidNY
0158763MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1619287398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077330736",
            "telephone_number": "732-324-5171",
            "fax_number": "732-324-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613654",
            "telephone_number": "732-324-5171",
            "fax_number": "732-324-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES OF CENTRAL JERSEY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "LONGO",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-324-5171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "MA67626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8069204",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02909108",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0158763",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.