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NPI Code Detail

MEDICARE: KATHLEEN REALE

MEDICARE: KATHLEEN REALE
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
1314000000XSkilled Nursing FacilityOC009683PA

General Provider Information

NPI Number : 1538375381
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN REALE
Provider Business Mailing Address
First Line : 1611 WINDSOR CT
Second Line :
City : LANSDALE
State : PA
Zip : 19446-4339
Country : US
Telephone Number : 215-361-9864
Fax Number :
Provider Business Practice Location Address
First Line : 305 CHERRY ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-1803
Country : US
Telephone Number : 800-974-6383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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Directions to “ KATHLEEN REALE ” Practice Location

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