Healthcare Provider Details

I. General information

NPI: 1922866953
Provider Name (Legal Business Name): KENNETH SAFLEY PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

5405 TUCKERMAN LN APT 802
NORTH BETHESDA MD
20852-7332
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-1982
  • Fax:
Mailing address:
  • Phone: 760-622-7150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: