MEDICARE: HENRY R KRANZLER 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
1	2084P0802X	Addiction Psychiatry Physician	MD440988	PA

General Provider Information

NPI Number	:	1205832201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY R KRANZLER MD

Provider Business Mailing Address
First Line	:	3900 CHESTNUT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3120
Country	:	US
Telephone Number	:	215-386-6662
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 CHESTNUT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3120
Country	:	US
Telephone Number	:	215-386-6662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	03/13/2014

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