1336566223 NPI number — ADVANCED PATHOLOGY ASSOCIATES, LLC

Table of content: MRS. ROSA MARGARITA ORTIZ FEBLES MA, MFTI (NPI 1508092651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336566223 NPI number — ADVANCED PATHOLOGY ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED PATHOLOGY ASSOCIATES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336566223
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 79906
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21279-0906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-566-1600
Provider Business Mailing Address Fax Number:
240-566-1605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7600 CARROLL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAKOMA PARK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20912-6367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-891-7600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CACCIABEVE
Authorized Official First Name:
NICOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
240-826-6093

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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