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Contact Information

MOUNTAIN LAKES PATHOLOGY LLC
115 ROUTE 46 W
SUITE B-12
MOUNTAIN LAKES, NJ07046-1668
 Phone: 973-809-7706
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for MOUNTAIN LAKES PATHOLOGY LLC

NPI # 1316225097
LBN Legal business name MOUNTAIN LAKES PATHOLOGY LLC
Authorized official ESSAM AHMED - (PRINCIPAL OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/28/2011
Last updated 07/28/2011 - About 15 years ago
Identifiers
NJ Medicaid 8065301
NJ Medicaid 8606005
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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