Individual
MR. KENNETH M PEARLSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 349-8310
(215) 662-2739
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 349-8310
(215) 662-2739
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN332454L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013979980001
—
PA
Enumeration date
10/24/2005
Last updated
10/19/2012
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