1437179769 NPI number — ONCO DIAGNOSTIC SERVICES INC

Table of content: DR. DAVID HILLEL ROBERTS MD (NPI 1558350660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437179769 NPI number — ONCO DIAGNOSTIC SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCO DIAGNOSTIC SERVICES INC
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:
6
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:
1437179769
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10401 OLD GEORGETOWN ROAD
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-530-5511
Provider Business Mailing Address Fax Number:
301-564-5748

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10401 OLD GEORGETOWN ROAD
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-530-5511
Provider Business Practice Location Address Fax Number:
301-564-5748
Provider Enumeration Date:
07/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROGOWSKI
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-530-5511

Provider Taxonomy Codes

  • Taxonomy code: 207ZD0900X , with the licence number:  560 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZM0300X , with the licence number: 560 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0101X , with the licence number: 560 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZC0500X , with the licence number: 560 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00064700 . This is a "RAILROAD MEDICARE PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".