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General NPI Number Information
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NPI Number | 1376358952
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Entity Type | Organization
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Legal Business Name | KCS MEDICAL CONSULTING LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 380 RED LION RD
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-6451
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Country | US
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Telephone | 267-277-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 7001 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-3941
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Country | US
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Telephone | 215-834-3656
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. OLUWATOBI EMMANUEL MENAWONU
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Credential | PHMNP
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Telephone | 215-834-3656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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