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General NPI Number Information
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NPI Number | 1669640116
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Entity Type | Organization
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Legal Business Name | KENSINGTON PATHOLOGY CONSULTANTS, INC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 1515 CHAIN BRIDGE RD STE G16
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City | MC LEAN
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State | VA
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Zip | 22101-4421
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Country | US
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Telephone | 703-893-0851
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Fax | 888-800-7899
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Provider Business Mailing Address
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Address Line | 1515 CHAIN BRIDGE RD STE G16
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City | MC LEAN
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State | VA
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Zip | 22101-4421
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Country | US
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Telephone | 703-893-0851
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Fax | 888-800-7899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AIZEN J MARROGI
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Credential | M.D
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Telephone | 301-801-6766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 0101231650
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 0101231650
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License Number State | VA
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