Provider Demographics
NPI:1427019207
Name:MORGENSTERN, KENNETH ELI (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ELI
Last Name:MORGENSTERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BLOOMINGDALE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4056
Mailing Address - Country:US
Mailing Address - Phone:610-687-8771
Mailing Address - Fax:610-687-8773
Practice Address - Street 1:123 BLOOMINGDALE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4056
Practice Address - Country:US
Practice Address - Phone:610-687-8771
Practice Address - Fax:610-687-8773
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063273L207W00000X, 207WX0200X
NJ25MA08145200207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0100188Medicaid
PA097198Medicare PIN
PA102973Medicare PIN
PAH58414Medicare UPIN
NJ121427X1BMedicare PIN