Provider Demographics
NPI:1447408646
Name:KENNETH LENTZ, MD
Entity Type:Organization
Organization Name:KENNETH LENTZ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-489-0900
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:STE 206
Mailing Address - City:N. CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022
Mailing Address - Country:US
Mailing Address - Phone:724-489-0900
Mailing Address - Fax:724-489-0930
Practice Address - Street 1:625 LINCOLN AVE
Practice Address - Street 2:STE 206
Practice Address - City:N. CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022
Practice Address - Country:US
Practice Address - Phone:724-489-0900
Practice Address - Fax:724-489-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA154780Medicare PIN