Provider Demographics
NPI:1851477293
Name:NEW KENSINGTON OPHTHALMOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEW KENSINGTON OPHTHALMOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REEM
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-335-6611
Mailing Address - Street 1:2300 FREEPORT RD
Mailing Address - Street 2:SUITE 6 FELDARELLI SQUARE
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-4669
Mailing Address - Country:US
Mailing Address - Phone:724-335-6611
Mailing Address - Fax:724-335-3711
Practice Address - Street 1:2300 FREEPORT RD
Practice Address - Street 2:SUITE 6 FELDARELLI SQUARE
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-4669
Practice Address - Country:US
Practice Address - Phone:724-335-6611
Practice Address - Fax:724-335-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
009565Medicare PIN
1229840001Medicare NSC