Provider Demographics
NPI:1356420483
Name:CAPE COD PATHOLOGY CONSULTANTS, P.C.
Entity type:Organization
Organization Name:CAPE COD PATHOLOGY CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-457-3536
Mailing Address - Street 1:100 TER HEUN DR
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2503
Mailing Address - Country:US
Mailing Address - Phone:508-457-3536
Mailing Address - Fax:
Practice Address - Street 1:100 TER HEUN DR
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2503
Practice Address - Country:US
Practice Address - Phone:508-457-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM13862Medicare ID - Type Unspecified