Delaware Clinical & Laboratory Physicians, PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

DELAWARE CLINICAL & LABORATORY PHYSICIANS, PA

Doing business as

Pathology DCLP

Practice address

4755 Ogletown Stanton Rd
Department of Pathology & Laboratory Medicine
Newark, DE 19718-0001

Phone

(302) 454-9830

Fax

(302) 454-1445

NPI assigned

Nov 6, 2006

Last updated

Mar 14, 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

Gary Witkin, MDNPI 1396741849

Title

President

Phone

(302) 454-9830

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pathology DCLP Doing business as

Locations

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.

• Gary Bruce Witkin, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Newark, DE
  • NPI 1396741849
  Authorized official Same address or phone

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1750460093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12210",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198502210",
            "telephone_number": "302-454-9830",
            "fax_number": "302-454-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "DEPARTMENT OF PATHOLOGY & LABORATORY MEDICINE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197180001",
            "telephone_number": "302-454-9830",
            "fax_number": "302-454-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE CLINICAL & LABORATORY PHYSICIANS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "WITKIN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-454-9830",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400302",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathology DCLP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anatomic Pathology & Clinical Pathology Physician in Newark, DE
• Providers in Newark, DE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Delaware

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