Provider Demographics
NPI:1548241516
Name:KENNTH ZAHL M.D., P.C.
Entity Type:Organization
Organization Name:KENNTH ZAHL M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNTH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-989-2644
Mailing Address - Street 1:3 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6902
Mailing Address - Country:US
Mailing Address - Phone:973-989-2644
Mailing Address - Fax:973-989-2645
Practice Address - Street 1:343 MOUNT HOPE AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-1644
Practice Address - Country:US
Practice Address - Phone:973-989-2644
Practice Address - Fax:973-989-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA056413207L00000X, 207LP2900X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Not Answered2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJZA440933Medicare ID - Type Unspecified