Provider Demographics
NPI:1396701660
Name:KINGSLEY LANE PATHOLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:KINGSLEY LANE PATHOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP ATTENDING PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-889-5069
Mailing Address - Street 1:PO BOX 758994
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-6412
Mailing Address - Country:US
Mailing Address - Phone:800-353-0788
Mailing Address - Fax:804-355-6031
Practice Address - Street 1:150 KINGSLEY LANE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505
Practice Address - Country:US
Practice Address - Phone:757-889-5069
Practice Address - Fax:804-355-6031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890158JMedicaid
VACL0674Medicare PIN
VAC02485Medicare ID - Type Unspecified