SKIN PATHOLOGY LABORATORY, INC. (NPI# 1073648069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073648069 |
| Entity Type | Organization |
| Organization Name | SKIN PATHOLOGY LABORATORY, INC. |
| Practice Address |
609 Albany St Fl 3 Boston MA 02118-2515 |
| Mailing Address |
680 Worcester Rd Framingham MA 01702-5259 |
| Practice Telephone | 6176385570 |
| Practice Fax Number | 6176385575 |
| Mailing Telephone | 5086202800 |
| Mailing Fax Number | 5086202808 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAG BHAWAN (PRESIDENT) |
| Authorized Official Telephone | 6176385570 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 9750878 | 05 |
| Street Address |
609 ALBANY ST FL 3 |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649372046 | Nancy Naguib | Dermatology | 150 S Hungtington Steet, Boston, MA 02130 | 2006-09-05 |
| 1932493053 | Whitney Lynn Tolpinrud | Dermatology | 75 Francis St, Boston, MA 02115-6110 | 2011-06-06 |
| 1730281296 | Miguel J Stadecker | Dermatology | 750 Washington St, Nemc Box 836, Boston, MA 02111-1526 | 2006-09-03 |
| 1073563698 | Lyn Mcdivitt Duncan | Dermatology | 55 Fruit St, Wrn 825, Boston, MA 02114 | 2006-05-12 |
| 1376532853 | Boston University Dermatology, Inc. | Dermatology | 725 Albany St, Shapiro Building, 8th Floor, Boston, MA 02118-2526 | 2005-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689944811 | Nantucket Dermatology, LLC | Dermatology | 4.5 Bartlett Rd, Nantucket, MA 02554 | 2012-01-04 |
| 1730287699 | Cape Cod Dermatopathology | Dermatology | 129 Airport Rd, Unit # 6, Hyannis, MA 02601-1856 | 2006-09-21 |
| 1871562363 | Lisa Harbury Lerner | Dermatology | 320 Needham St, Suite 200, Newton, MA 02464-1592 | 2006-03-16 |
| 1477522910 | Cohen Dermatopathology, P.C. | Dermatology | 15 Crawford Street, Suite 100, Needham, MA 02494 | 2006-03-16 |
| 1043206527 | Elsa Velazquez | Dermatology | 15 Crawford St Ste 100, Needham, MA 02494-2618 | 2005-09-21 |
| 1497256317 | Goldberg Dermatology, LLC | Dermatology | 990 Paradise Rd, Swampscott, MA 01907-1395 | 2018-02-26 |
| 1992017230 | Katherine Fening | Dermatology | 1101 Beacon St, Suite 1e, Brookline, MA 02446-5587 | 2010-07-01 |
| 1619986114 | Karen C. Mitchell | Dermatology | 340 Maple St, Suite 203, Marlborough, MA 01752-3200 | 2006-08-05 |
| 1255370904 | Yvonne C Hines | Dermatology | 555 Pleasant St, Suite 106, Attleboro, MA 02703-2400 | 2006-06-06 |
| 1275589624 | Dermatopath Lab, Inc. | Dermatology | 555 Pleasant St, Suite 106, Attleboro, MA 02703-2400 | 2006-05-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.