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Organization

MLC PATHOLOGY, INC.

Active
Other names
leo lo conte
Organization subpart
No

Provider details

NPI number
Authorized official
MANLIO (LEO) AUGUSTUS LOCONTE M.D., MPH, FCAP (PRESIDENT)
(781) 861-9649
Entity
Organization

Contact information

Practice address
6 ANGIER RD, LEXINGTON, MA 02420-1609
(781) 861-9649
(781) 863-8031
Mailing address
6 ANGIER RD, LEXINGTON, MA 02420-1609
(781) 861-9649
(781) 863-8031

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102055200
FEDERAL WORKERS COMP
01
22D0650118
CLIA
01
612830
TUFTS
MA
05
9782737
MA
01
DA4871
RAILROAD MEDICARE
01
M16670
BLUE CROSS
MA
Enumeration date
04/27/2006
Last updated
01/13/2012
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