Provider Demographics
NPI:1134260029
Name:KENSINGTON PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:KENSINGTON PHYSICAL THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:240-864-1800
Mailing Address - Street 1:20745 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-1906
Mailing Address - Country:US
Mailing Address - Phone:240-864-1800
Mailing Address - Fax:240-779-2121
Practice Address - Street 1:20745 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:BROOKEVILLE
Practice Address - State:MD
Practice Address - Zip Code:20833-1906
Practice Address - Country:US
Practice Address - Phone:240-864-1800
Practice Address - Fax:240-779-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD216535Medicare ID - Type Unspecified