1487924270 NPI number — JAMES M. KENSICKI, PC

Table of content: (NPI 1487924270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487924270 NPI number — JAMES M. KENSICKI, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES M. KENSICKI, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487924270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4130 RITTENHOUSE LANE
Provider Second Line Business Mailing Address:
P.O. BOX 707
Provider Business Mailing Address City Name:
SKIPPACK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19474
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-209-2596
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 N BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOYLESTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18901-3408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-230-8100
Provider Business Practice Location Address Fax Number:
215-230-8892
Provider Enumeration Date:
01/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KENSICKI
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-209-2596

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT016650 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)