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General NPI Number Information
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NPI Number | 1114221280
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL SERVICES OF HOLY CROSS
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 3720 FARRAGUT AVE
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City | KENSINGTON
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State | MD
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Zip | 20895-2110
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Country | US
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Telephone | 301-949-4242
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Fax | 301-949-8041
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Provider Business Mailing Address
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Address Line | PO BOX 531863
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City | ATLANTA
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State | GA
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Zip | 30353-1863
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP & CFO
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Name | JULIE KEESE
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Credential |
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Telephone | 301-754-7201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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