Provider Demographics
NPI:1053366054
Name:ENGLEWOOD PATHOLOGISTS, PA
Entity type:Organization
Organization Name:ENGLEWOOD PATHOLOGISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-894-3425
Mailing Address - Street 1:PO BOX 8069
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-8069
Mailing Address - Country:US
Mailing Address - Phone:201-894-3420
Mailing Address - Fax:201-871-2269
Practice Address - Street 1:350 ENGLE ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1808
Practice Address - Country:US
Practice Address - Phone:201-894-3420
Practice Address - Fax:201-871-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ111169Medicare ID - Type Unspecified