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Organization
UNIVERSITY PATHOLOGISTS, LLC
Active
Organization
UNIVERSITY PATHOLOGISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILA KHORSAND (MD)
(401) 921-0252
Entity
Organization
Contact information
Practice address
825 CHALKSTONE AVE, RWMC - PATHOLOGY DEPARTMENT, PROVIDENCE, RI 02908-4728
(401) 456-2662
(401) 456-2663
Mailing address
67 SLADES FERRY AVE STE 6720, SOMERSET, MA 02726-1220
(401) 921-0252
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207ZC0006X
Clinical Pathology Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9784730
—
MA
Enumeration date
02/08/2008
Last updated
04/13/2021
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