Active NPI
Pennje Laboratory Services, LLC
- Anatomic Pathology Physician
- Bethlehem, PA
National Provider Identifier
1770717365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- PA-MD047282L
- Legal business name
- PENNJE LABORATORY SERVICES, LLC
- Practice address
- 2591 Baglyos Circle
Suite C-48
Bethlehem, PA 18020 - Phone
- (484) 821-0520
- Fax
- (484) 821-0530
- NPI assigned
- May 11, 2009
- Last updated
- May 11, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mohamed A Abdulla, MD, FCAP
- Title
- Medical Director
- Phone
- (484) 821-0520
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | NJ-25MA07827100 | NJ | |
| Cytopathology Physician | 207ZC0500X | MYC-232717 | NY | |
| Cytopathology Physician | 207ZC0500X | PA-MD047282L | PA | |
| Dermatopathology (Pathology) Physician | 207ZD0900X | NJ-25MA07827100 | NJ | |
| Dermatopathology (Pathology) Physician | 207ZD0900X | NY-232717 | NY | |
| Dermatopathology (Pathology) Physician | 207ZD0900X | PA-MD047282L | PA | |
| Anatomic Pathology Physician | 207ZP0101X | NJ-25MA07827100 | NJ | |
| Anatomic Pathology Physician | 207ZP0101X | NYC-232717 | NY | |
| Anatomic Pathology Physician | 207ZP0101X | PA-MD047282L | PA | Primary |
Addresses
Primary practice location
2591 Baglyos Circle
Suite C-48
Bethlehem, PA 18020
Mailing address
2591 Baglyos Circle
Suite C-48
Bethlehem, PA 18020
Phone (484) 821-0520
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0060275 | Medicaid | PA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242000000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1242000000000",
"number": "1770717365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2591 BAGLYOS CIRCLE",
"address_2": "SUITE C-48",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "18020",
"telephone_number": "484-821-0520",
"fax_number": "484-821-0530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2591 BAGLYOS CIRCLE",
"address_2": "SUITE C-48",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "18020",
"telephone_number": "484-821-0520",
"fax_number": "484-821-0530"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENNJE LABORATORY SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-11",
"last_updated": "2009-05-11",
"status": "A",
"authorized_official_last_name": "ABDULLA",
"authorized_official_first_name": "MOHAMED",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "484-821-0520",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD, FCAP"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "NJ",
"license": "NJ-25MA07827100",
"primary": false
},
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "NY",
"license": "MYC-232717",
"primary": false
},
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "PA",
"license": "PA-MD047282L",
"primary": false
},
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "NJ",
"license": "NJ-25MA07827100",
"primary": false
},
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "NY",
"license": "NY-232717",
"primary": false
},
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "PA",
"license": "PA-MD047282L",
"primary": false
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "NJ",
"license": "NJ-25MA07827100",
"primary": false
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "NY",
"license": "NYC-232717",
"primary": false
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "PA",
"license": "PA-MD047282L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0060275",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
- Tribhuvan Kumar Pendurthi, M.D.
- Rick Alexander Pendzick, PA - C
- Adam Pengh, ATC, CSCS
- Penn Dental Arts PC (Gaspari family dental care)
- Penn Facial Imaging Inc
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- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01036)
- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01311)
- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #00820)
- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy # 05533)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.