Organization
LABORATORY OF DERMATOPATHOLOGY ADX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRATTENDICK (CFO)
(561) 514-5822
Entity
Organization
Contact information
Practice address
80 CROSSWAYS PARK DRIVE, SUITE 100, WOODBURY, NY 11797-2047
(516) 944-3883
(516) 833-2936
Mailing address
11025 RCA CENTER DR, SUITE 300, PALM BEACH GARDENS, FL 33410-4269
(561) 514-5822
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
PFI 3199
NY
Other
Enumeration date
08/05/2006
Last updated
08/28/2019
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