Martin, Kenneth J

Martin, Kenneth J is an individual health care provider with primary practice located at 7331 Brentwood Rd , Philadelphia PA 19151. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Martin, Kenneth J can be contacted via phone (215) 877-2555.

Contact Information

Primary practice address
7331 Brentwood Rd Philadelphia PA 19151
Phone: (215) 877-2555
Fax: (215) 877-0240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC002881L Pennsylvania

Profile Details

NPI number 1285626804
LBN Legal business name Martin, Kenneth J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jan 26th, 2015 - about 11 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 1285626804 NPPES
Pennsylvania Other 0060738000 IBC
Pennsylvania Other 11940 IBC
Pennsylvania Other 31875 IBC
Pennsylvania Other 0104650501 IBC
Pennsylvania Other 1480 IBC
Pennsylvania Other 175404 IBC
Pennsylvania MEDICAID 0010465050004 IBC

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