DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KAOSOLUCHI ENENDU MD

MEDICARE: KAOSOLUCHI ENENDU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianMD494104PA
22084P0800XPsychiatry PhysicianA197583CA

General Provider Information

NPI Number : 1184204695
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAOSOLUCHI ENENDU MD
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6516
Fax Number : 570-271-5814
Provider Business Practice Location Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-9800
Country : US
Telephone Number : 570-271-6516
Fax Number : 570-271-5814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2021
Last Update Date : 04/23/2026

Similar Medicare Providers

1164366043 — DR. MARK LOTFALLA DO
Practice Location Address:
100 N ACADEMY AVE
DANVILLE, PA
17822-9800
Practice Phone: 570-271-6812
Practice Fax:
1831034750 — FAZEEL QAMAR
Practice Location Address:
100 N ACADEMY AVE # MC20-25
DANVILLE, PA
17822-9800
Practice Phone: 570-271-6775
Practice Fax:
1710822531 — ALICIA SAWYERS
Practice Location Address:
100 N ACADEMY AVE
DANVILLE, PA
17822-9800
Practice Phone: 570-271-6211
Practice Fax:
1083364285 — DR. HUGH NGOCTRI HUYNH MD
Practice Location Address:
100 N ACADEMY AVE
DANVILLE, PA
17822-9800
Practice Phone: 570-271-6775
Practice Fax: 570-271-6762
1063357671 — MRS. ANDREA MELISSA MARTINEZ MD
Practice Location Address:
100 N ACADEMY AVE
DANVILLE, PA
17822-9800
Practice Phone: 570-271-6692
Practice Fax:
1972398014 — ELHAM SHAHREKI MD
Practice Location Address:
100 N ACADEMY AVE
DANVILLE, PA
17822-9800
Practice Phone: 570-214-1477
Practice Fax:

Directions to “ KAOSOLUCHI ENENDU MD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.