Provider Demographics
NPI:1881781409
Name:HENRY J. KANAREK M.D. PA
Entity type:Organization
Organization Name:HENRY J. KANAREK M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER / BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-451-8555
Mailing Address - Street 1:4601 W. 109TH STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1349
Mailing Address - Country:US
Mailing Address - Phone:913-451-8555
Mailing Address - Fax:913-327-8553
Practice Address - Street 1:4601 W 109TH STREET
Practice Address - Street 2:SUITE 350
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1349
Practice Address - Country:US
Practice Address - Phone:913-451-8555
Practice Address - Fax:913-327-8553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty