Organization
STATE OF NEW YORK
Active
Other names
SUNY DMC @ LICH-PATHOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN VIENTOS-SOTIRIADIS (COO)
(718) 270-2025
Entity
Organization
Contact information
Practice address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1000
Mailing address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1000
Taxonomy
Speciality
Code
Description
License number
State
207ZI0100X
Immunopathology Physician
—
—
207ZN0500X
Neuropathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
03/10/2011
Last updated
04/04/2013
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