Provider Demographics
NPI:1841719093
Name:KERN, NATHANIEL PAUL (MD, ATC, CSCS)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:PAUL
Last Name:KERN
Suffix:
Gender:
Credentials:MD, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 RISING SUN RD
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2713
Mailing Address - Country:US
Mailing Address - Phone:610-730-1983
Mailing Address - Fax:
Practice Address - Street 1:915 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1394
Practice Address - Country:US
Practice Address - Phone:610-730-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR81696390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program