Organization
EASTPATHLAB LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. QIANGHUA CHEN M.D. (CEO)
(516) 503-7439
Entity
Organization
Contact information
Practice address
136-16 31 RD., SUITE 2B, FLUSHING, NY 11354
(718) 279-1271
(718) 279-1092
Mailing address
22 SHADETREE LANE, ROSLYN HEIGHTS, NY 11577
(718) 279-1271
(718) 279-1092
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33D2110448
CLIA
—
Enumeration date
09/19/2016
Last updated
09/19/2016
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