Provider Demographics
NPI:1205882842
Name:DENNIS KREINBROOK
Entity type:Organization
Organization Name:DENNIS KREINBROOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH D
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:WHERLE
Authorized Official - Last Name:KREINBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:724-836-3960
Mailing Address - Street 1:40 HUFF AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5318
Mailing Address - Country:US
Mailing Address - Phone:724-836-3960
Mailing Address - Fax:724-836-2876
Practice Address - Street 1:40 HUFF AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5318
Practice Address - Country:US
Practice Address - Phone:724-836-3960
Practice Address - Fax:724-836-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080631SWCMedicare PIN