Crystal Lake Pathology PC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

CRYSTAL LAKE PATHOLOGY PC

Practice address

242 Green St
Gardner, MA 01440

Phone

(978) 630-6535

NPI assigned

Jul 14, 2017

Organization subpart

No

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

Authorized official

Name

Maha Farhat, MD

Title

Pathologist

Phone

(617) 645-1511

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Devayani C. Lathi, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Gardner, MA
  • NPI 1811984461
  NPD (past)

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1730601303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "01440",
            "telephone_number": "978-630-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL LAKE PATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "FARHAT",
        "authorized_official_first_name": "MAHA",
        "authorized_official_title_or_position": "PATHOLOGIST",
        "authorized_official_telephone_number": "617-645-1511",
        "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": []
}

• Wendy J Coutu, NP
• Maggie-Claire Critchlow
• Criterion
• Odalys Machin Croteau, MD
• Teresa Croteau, PHARMD
• Sarah Zane Cuenca, LMHC
• Susan Jane Cutler, MED
• CVS Pharmacy Inc (CVS Pharmacy #02098)
• D'Ambrosio Eye Care, Inc.
• D'Ambrosio Eye Care, Inc.

• Anatomic Pathology & Clinical Pathology Physician in Gardner, MA
• Providers in Gardner, MA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; 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.