Krevolin, Larry E

Krevolin, Larry E is an individual health care provider with primary practice located at 235 N Broad St Suite 200 Clinical Nephrology Assoc, Philadelphia PA 19107-1511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Krevolin, Larry E can be contacted via phone (215) 762-7785.

Contact Information

Primary practice address
235 N Broad St Suite 200 Clinical Nephrology Assoc Philadelphia PA 19107-1511
Phone: (215) 762-7785
Fax: (215) 568-6007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 05003817L Pennsylvania
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 25MB03667100 New Jersey

Profile Details

NPI number 1265532923
LBN Legal business name Krevolin, Larry E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2006
Last updated Dec 16th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265532923 NPPES
Pennsylvania MEDICAID 000792539

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