Organization
SOUTHERN REGIONAL PATHOLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MAPOW (PRESIDENT)
(856) 690-1025
Entity
Organization
Contact information
Practice address
1505 W SHERMAN AVE, VINELAND, NJ 08360-6912
(856) 690-1025
(856) 690-1352
Mailing address
PO BOX 754, MILLVILLE, NJ 08332-0754
(856) 690-1025
(856) 690-1352
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0491213000
AMERIHEALTH
NJ
05
—
8186006
—
NJ
Enumeration date
07/13/2006
Last updated
08/03/2010
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