Provider Demographics
NPI:1265607188
Name:KENNETH LEFKOWITZ
Entity type:Organization
Organization Name:KENNETH LEFKOWITZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-230-9707
Mailing Address - Street 1:252 W SWAMP RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2422
Mailing Address - Country:US
Mailing Address - Phone:215-230-9707
Mailing Address - Fax:215-348-5106
Practice Address - Street 1:252 W SWAMP RD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2422
Practice Address - Country:US
Practice Address - Phone:215-230-9707
Practice Address - Fax:215-348-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003778R332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013957020002Medicaid
PA0013957020002Medicaid
PA4212620001Medicare NSC
PAU37160Medicare UPIN