Provider Demographics
NPI:1437179769
Name:ONCO DIAGNOSTIC SERVICES INC
Entity Type:Organization
Organization Name:ONCO DIAGNOSTIC SERVICES INC
Other - Org Name:ONCO DIAGNOSTIC SYSTEMS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROGOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-530-5511
Mailing Address - Street 1:10401 OLD GEORGETOWN ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-530-5511
Mailing Address - Fax:301-564-5748
Practice Address - Street 1:10401 OLD GEORGETOWN ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-530-5511
Practice Address - Fax:301-564-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD560207ZC0500X, 207ZD0900X, 207ZM0300X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Multi-Specialty
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Multi-Specialty
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical MicrobiologyGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00064700OtherRAILROAD MEDICARE PTAN
MDP00064700OtherRAILROAD MEDICARE PTAN