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Organization

90 CAFFERTY ROAD OPERATING COMPANY, LP

Active
Other names
Pediatric Specialty Care at Point Pleasant
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
90 CAFFERTY ROAD, POINT PLEASANT, PA 18950-0217
(215) 297-5555
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 361-6636

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
135770
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
135770
PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
PA
01
135830
PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
PA
01
136680
PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
PA
Enumeration date
02/07/2011
Last updated
09/23/2024
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