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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