Provider Demographics
NPI:1043504566
Name:CARNEY PATHOLOGY, INC.
Entity type:Organization
Organization Name:CARNEY PATHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:FALLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-296-4012
Mailing Address - Street 1:1342 BELMONT ST
Mailing Address - Street 2:C/O HEALTH MANAGEMENT ASSOC., SUITE 205
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4436
Mailing Address - Country:US
Mailing Address - Phone:508-580-1670
Mailing Address - Fax:508-586-1741
Practice Address - Street 1:2100 DORCHESTER AVE
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:DORCHESTER CENTER
Practice Address - State:MA
Practice Address - Zip Code:02124-5615
Practice Address - Country:US
Practice Address - Phone:617-296-4012
Practice Address - Fax:617-474-3847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty