Provider Demographics
NPI:1649276403
Name:TOTO, KENNETH M (PA)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:M
Last Name:TOTO
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:101 S BRYN MAWR AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3123
Mailing Address - Country:US
Mailing Address - Phone:610-527-9500
Mailing Address - Fax:610-527-9529
Practice Address - Street 1:101 S BRYN MAWR AVE
Practice Address - Street 2:STE 200
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3123
Practice Address - Country:US
Practice Address - Phone:610-527-9500
Practice Address - Fax:610-527-9529
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA000337L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
046270Medicare ID - Type Unspecified