Provider Demographics
NPI:1649434556
Name:KASENETZ, PAMELA HILARY (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:HILARY
Last Name:KASENETZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2800 S SHIRLINGTON RD
Mailing Address - Street 2:STE 410
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3601
Mailing Address - Country:US
Mailing Address - Phone:703-533-2222
Mailing Address - Fax:703-533-3421
Practice Address - Street 1:2800 S SHIRLINGTON RD
Practice Address - Street 2:STE 410
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3601
Practice Address - Country:US
Practice Address - Phone:703-533-2222
Practice Address - Fax:703-533-3421
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2017-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0116020354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
246757ZW6Medicare PIN