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General NPI Number Information
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NPI Number | 1700067394
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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 | 11/25/2007
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Last Update Date | 11/25/2007
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Provider Practice Location Address
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Address Line | 8426 SPARGER ST
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City | MC LEAN
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State | VA
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Zip | 22102-1731
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Country | US
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Telephone | 703-356-1802
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Fax |
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Provider Business Mailing Address
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Address Line | 8426 SPARGER ST
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City | MC LEAN
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State | VA
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Zip | 22102-1731
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Country | US
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Telephone | 703-356-1802
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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