Dermatopathology Laboratory of New England PC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CL0562 Issued in CT

Legal business name

DERMATOPATHOLOGY LABORATORY OF NEW ENGLAND PC

Practice address

140 Green Rd
Meriden, CT 06450-6612

Phone

(203) 630-2666

Fax

(203) 630-2909

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Philip Edwin Shapiro, MDNPI 1477561389

Title

President

Phone

(208) 630-2666

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Earl J Glusac, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • New Haven, CT
  • NPI 1063493377
  Medicare reassignment Care Compare group NPD
• Philip Edwin Shapiro, MD

  • Dermatopathology (Pathology) Physician
  • Meriden, CT
  • NPI 1477561389

  Dermatology

  Medicare reassignment NPD Authorized official
• Alicia Coen Sigal, MD

  • Dermatology Physician
  • Meriden, CT
  • NPI 1801005673
  Medicare reassignment Care Compare group NPD
• Noel Arthur Joseph Turner, MD

  • Dermatology Physician
  • Madison, CT
  • NPI 1386209237
  Medicare reassignment Care Compare group NPD
• Jonathan R Zirn, MD

  • Dermatology Physician
  • Danbury, CT
  • NPI 1306896287
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1912915828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GREEN RD",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506612",
            "telephone_number": "203-630-2666",
            "fax_number": "203-630-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GREEN RD",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506612",
            "telephone_number": "203-630-2666",
            "fax_number": "203-630-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOPATHOLOGY LABORATORY OF NEW ENGLAND PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-630-2666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CT",
            "license": "029159",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CT",
            "license": "CL0562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "070CL0562CT01",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236081",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Michael Demchak
• Dental Group of Meriden-Wallingford
• Anthony Depalma, D.O.
• Rianna Gloria Depalma, RN
• Kaitlyn Depathy, PA-C
• Melanie Ciner Devito, LCSW
• Roger C Dezinno
• Victor Manuel Diaz-Rodriguez, RRT
• Damaris Diaz, RN
• Janet B Dickinson, MD

• Clinical Medical Laboratory in Meriden, CT
• Providers in Meriden, CT by specialty
• Clinical Medical Laboratory in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.