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Organization
KENHORST FAMILY MEDICAL CENTER
Active
Organization
KENHORST FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EZZAT A HANNA MD (OWNER)
(610) 775-2799
Entity
Organization
Contact information
Practice address
600 HIGH BLVD, KENHORST, PA 19607-0347
(610) 775-2799
(610) 775-3284
Mailing address
600 HIGH BLVD, PO BOX 347, KENHORST, PA 19607-0347
(610) 775-2799
(610) 775-3284
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02420100
CAPITAL BLUE CROSS
PA
01
—
503515
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/29/2005
Last updated
08/22/2020
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