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Organization
PRINCETON PATHOLOGY SERVICES PA
Active
Organization
PRINCETON PATHOLOGY SERVICES PA
Active
Other names
PRINCETON PATHOLOGY SERVICES PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO GONZALEZ MD (OWNER/PRESIDENT)
(813) 490-7206
Entity
Organization
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(407) 422-9831
(302) 416-6097
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
(407) 648-2065
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083151
—
NJ
Enumeration date
10/03/2007
Last updated
04/10/2025
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