Provider Demographics
NPI:1609572122
Name:KENSINGTON HOSPITAL MEDICAL REHAB
Entity Type:Organization
Organization Name:KENSINGTON HOSPITAL MEDICAL 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 DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-1797
Mailing Address - Country:US
Mailing Address - Phone:215-426-8100
Mailing Address - Fax:267-861-6410
Practice Address - Street 1:136 DIAMOND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-1797
Practice Address - Country:US
Practice Address - Phone:215-426-8100
Practice Address - Fax:267-861-6410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENSINGTON HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA860231OtherDEPT OF DRUG & ALCOHOL LICENSURE