Organization
425 CEDARCREST ROAD OPERATING COMPANY, LP
Active
Other names
Pediatric Specialty Care at Quakertown
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY KENWORTHY (SR. DIRECTOR REVENUE CYCLE MGMT)
(716) 361-6636
Entity
Organization
Contact information
Practice address
425 CEDAR CREST DR, QUAKERTOWN, PA 18951-1620
(215) 804-0736
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 361-6636
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
136710
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136710
PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
PA
Enumeration date
02/11/2011
Last updated
09/23/2024
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