Individual
DR. JUANITA REGINA KCOMT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
735 FITZWATERTOWN RD, #1, WILLOW GROVE, PA 19090-1332
(215) 657-2012
(215) 657-2018
Mailing address
735 FITZWATERTOWN RD, #1, WILLOW GROVE, PA 19090-1332
(215) 657-2012
(215) 657-2018
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD432340
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10963034002
—
PA
Enumeration date
08/30/2006
Last updated
05/26/2010
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