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General NPI Number Information
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NPI Number | 1922048230
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Entity Type | Organization
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Legal Business Name | ALEXANDRIA PERINATAL DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 4320 SEMINARY ROAD INOVA ALEXANDRIA HOSPITAL DIAGNOSTIC CENTER
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1535
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Country | US
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Telephone | 703-504-7868
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Fax | 703-504-7733
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Provider Business Mailing Address
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Address Line | 2876 GUARDIAN LANE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7327
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Country | US
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Telephone | 757-463-5240
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Fax | 757-463-6572
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Authorized Official
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Title or Position | ADMINISTRATOR INOVA ALEXANDRIA HOSP
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Name | KENNETH H KOZLOFF
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Credential | FACHE
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Telephone | 703-504-3167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology 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 | 207SC0300X
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Taxonomy Name | Clinical Cytogenetics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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