Healthcare Provider Details

I. General information

NPI: 1346842275
Provider Name (Legal Business Name): KENSINGTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 W DIAMOND STREET
PHILADELPHIA PA
19122-1721
US

IV. Provider business mailing address

136 W DIAMOND STREET
PHILADELPHIA PA
19122-1721
US

V. Phone/Fax

Practice location:
  • Phone: 215-426-8100
  • Fax: 215-965-2344
Mailing address:
  • Phone: 215-426-8100
  • Fax: 215-965-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIA ZUKOWSKI
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 215-426-8100