Individual
KENNETH W. GENTILEZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5 MORGAN HWY, SUITE 4, SCRANTON, PA 18508-2641
(570) 344-3788
(570) 969-9280
Mailing address
5 MORGAN HWY, SUITE 4, SCRANTON, PA 18508-2641
(570) 344-3788
(570) 969-9280
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD040119L
PA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD040119L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001216964-0002
—
PA
01
—
076550
BLUE CARE HMO (FPH)
PA
01
—
20038434
AMERIHEALTH
PA
01
—
250002212
RAILROAD MEDICARE
PA
01
—
251645055
UNITEDHEALTH CARE
PA
01
—
476988
BLUE CARE
PA
01
—
536118
AETNA
PA
01
—
70303-1067
GEISINGER
PA
Enumeration date
08/30/2005
Last updated
02/16/2015
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