Individual
RENEE KENDZIERSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140
(215) 707-7237
(215) 707-9389
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7237
(215) 707-9389
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS010808L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0040533
—
NJ
05
—
1010761130001
—
PA
01
—
11439458
CAQH
—
01
—
1396272
UNITED HEALTHCARE
—
01
—
2851114000
AMERIHEALTH HMO
—
01
—
60033560
HORIZON NJ HEALTH
—
01
—
7464884
AETNA
—
01
—
A3738029
OXFORD HEALTH
—
01
—
KE001978102
HIGHMARK PA BLUE SHIELD
—
Enumeration date
10/13/2005
Last updated
07/29/2019
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