Healthcare Provider Details

I. General information

NPI: 1487924270
Provider Name (Legal Business Name): JAMES M. KENSICKI, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 N BROAD ST
DOYLESTOWN PA
18901-3408
US

IV. Provider business mailing address

4130 RITTENHOUSE LANE P.O. BOX 707
SKIPPACK PA
19474
US

V. Phone/Fax

Practice location:
  • Phone: 215-230-8100
  • Fax: 215-230-8892
Mailing address:
  • Phone: 610-209-2596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT016650
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JAMES M KENSICKI JR.
Title or Position: PRESIDENT
Credential: P.T.
Phone: 610-209-2596