=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205955366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARASITOLOGY LABORATORY OF WASHINGTON
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2141 K ST NW SUITE 408
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20037-1810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-331-0287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2141 K ST, NW SUITE 408
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MARTIN S. WOLFE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 202-331-0287
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------