Provider Demographics
NPI:1659342228
Name:KASLOFF, ILENE M (MD)
Entity Type:Individual
Prefix:MISS
First Name:ILENE
Middle Name:M
Last Name:KASLOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ILENE
Other - Middle Name:M
Other - Last Name:SLOVIKOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10400 EATON PLACE
Mailing Address - Street 2:#410
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-359-5160
Mailing Address - Fax:703-383-9574
Practice Address - Street 1:2579 JOHN MILTON DRIVE
Practice Address - Street 2:#310
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171
Practice Address - Country:US
Practice Address - Phone:703-860-4200
Practice Address - Fax:703-860-1528
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics