NPIMap

Organization Active NPI

Maplewood Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Albany, NY
National Provider Identifier
1619969870
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
MAPLEWOOD PATHOLOGY PC
Practice address
315 S Manning Blvd
SPH Pathology
Albany, NY 12208-1707
Phone
(518) 525-1474
Fax
(518) 525-6750
NPI assigned
Aug 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Authorized official

Name
Lisle Eaton, MD
Title
President
Phone
(518) 525-1424

Specialties & licenses 1

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

Addresses

Primary practice location

315 S Manning Blvd
SPH Pathology
Albany, NY 12208-1707

Mailing address

PO Box 8870
Maplewood Pathology
Albany, NY 12208-0870
Phone (518) 525-1424

Other identifiers 2

IdentifierTypeStateIssuer
33DPFI0004OtherNYCLIA
33D0162320OtherNYCLIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1619969870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8870",
            "address_2": "MAPLEWOOD PATHOLOGY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122080870",
            "telephone_number": "518-525-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "SPH PATHOLOGY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1474",
            "fax_number": "518-525-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD PATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "LISLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-525-1424",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "33DPFI0004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "33D0162320",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.