Provider Demographics
NPI:1508401480
Name:KJF UROLOGY LLC
Entity Type:Organization
Organization Name:KJF UROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-431-5718
Mailing Address - Street 1:640 CLOVELLY LN
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1847
Mailing Address - Country:US
Mailing Address - Phone:484-431-5718
Mailing Address - Fax:484-480-2987
Practice Address - Street 1:640 CLOVELLY LN
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1847
Practice Address - Country:US
Practice Address - Phone:484-431-5718
Practice Address - Fax:484-480-2987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty