Provider Demographics
NPI:1013959469
Name:KAGEN & BARDIN ASSOCIATES LLP
Entity Type:Organization
Organization Name:KAGEN & BARDIN ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-654-7412
Mailing Address - Street 1:8200 FLOURTOWN AVENUE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038
Mailing Address - Country:US
Mailing Address - Phone:215-233-1555
Mailing Address - Fax:215-233-0308
Practice Address - Street 1:8200 FLOURTOWN AVENUE
Practice Address - Street 2:SUITE 6
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038
Practice Address - Country:US
Practice Address - Phone:215-233-1555
Practice Address - Fax:215-233-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACI4308OtherRAILROAD MEDICARE
PA0019469160002Medicaid
PA872562Medicare PIN