Provider Demographics
NPI:1417557174
Name:KENSINGTON HOSPITAL NON HOSPITAL SHORT TERM/LONG TERM REHAB
Entity Type:Organization
Organization Name:KENSINGTON HOSPITAL NON HOSPITAL SHORT TERM/LONG TERM REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-426-8100
Mailing Address - Street 1:136 W. DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-1721
Mailing Address - Country:US
Mailing Address - Phone:215-426-8100
Mailing Address - Fax:215-965-2344
Practice Address - Street 1:136 W. DIAMOND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-1721
Practice Address - Country:US
Practice Address - Phone:215-426-8100
Practice Address - Fax:215-965-2344
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENSINGTON HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health