Provider Demographics
NPI:1881922292
Name:KENNETH VARANO DO INC.
Entity type:Organization
Organization Name:KENNETH VARANO DO INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:877-278-3697
Mailing Address - Street 1:555 CROTON RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3176
Mailing Address - Country:US
Mailing Address - Phone:877-278-3697
Mailing Address - Fax:877-278-3698
Practice Address - Street 1:555 CROTON RD
Practice Address - Street 2:SUITE 140
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3176
Practice Address - Country:US
Practice Address - Phone:877-278-3697
Practice Address - Fax:877-278-3698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009028L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty