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Organization
PATHOLOGY ASSOCIATES OF CENTRAL JERSEY INC.
Active
Organization
PATHOLOGY ASSOCIATES OF CENTRAL JERSEY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY LEE LONGO M.D. (PRESIDENT)
(732) 324-5171
Entity
Organization
Contact information
Practice address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3654
(732) 324-5171
(732) 324-4999
Mailing address
PO BOX 736, HOLMDEL, NJ 07733-0736
(732) 324-5171
(732) 324-4999
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MA67626
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158763
—
NJ
05
—
02909108
—
NY
05
—
8069204
—
NJ
Enumeration date
10/15/2010
Last updated
06/24/2013
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