Provider Demographics
NPI:1558524801
Name:VARGHESE-KROLL, ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:VARGHESE-KROLL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:122 SLADE AVE STE 101
Mailing Address - Street 2:CENTERS FOR REHABILITATION, PAIN MANAGEMENT & WELLNESS
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4917
Mailing Address - Country:US
Mailing Address - Phone:410-383-4263
Mailing Address - Fax:410-383-4005
Practice Address - Street 1:122 SLADE AVE STE 101
Practice Address - Street 2:CENTERS FOR REHABILITATION, PAIN MANAGEMENT & WELLNESS
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4917
Practice Address - Country:US
Practice Address - Phone:410-383-4263
Practice Address - Fax:410-383-4005
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2009-01104208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation