Peter Shaun Kavanaugh in Philadelphia - Chiropractor
Peter Shaun Kavanaugh - NPI 1154484111
Peter Shaun Kavanaugh is a Chiropractor in Philadelphia, Pennsylvania. Peter Shaun Kavanaugh practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Peter Shaun Kavanaugh is 1154484111. The last update date is 2012-02-07.
Peter Shaun Kavanaugh's current location address is 3301 Ryan Ave, Philadelphia, Pennsylvania. You can contact this provider via phone number 2153328686 and fax number 2153328691. The mailing address for Peter Shaun Kavanaugh is 3301 Ryan Ave, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Peter Shaun Kavanaugh |
|---|---|
| Address | 3301 Ryan Ave, Philadelphia, Pennsylvania |
| Phone Number | 2153328686 |
| Fax Number | 2153328691 |
| Sole Proprietor | Y |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1154484111 |
|---|---|
| Provider Enumeration Date | 2006-12-19 |
| Last Updated Date | 2012-02-07 |
Provider Mailing Address Detail
| Address | 3301 Ryan Ave |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 19136 |
| Phone Number | 2153328686 |
| Fax Number | 2153328691 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 1897 |
|
Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 61018000 | PA | KEYSTONE | |
| 87374 | PA | -- | |
| 2142140000 | PA | PERSONAL CHOICE |
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What is the unique 10-digit identification code issued to Peter Shaun Kavanaugh by the Centers for Medicare & Medicaid Services?
The Peter Shaun Kavanaugh has been assigned the NPI (National Provider Identifier) 1154484111 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Peter Shaun Kavanaugh?
The Peter Shaun Kavanaugh is situated at 3301 Ryan Ave, in the city of Philadelphia, state of PA, with the zip code 19136.
What is the Peter Shaun Kavanaugh's specialty and taxonomy code?
The Peter Shaun Kavanaugh's specialty is Chiropractor, and the corresponding taxonomy code is 111N00000X.
On what date did Peter Shaun Kavanaugh receive its 1154484111 assignment from the Centers for Medicare & Medicaid Services?
The Peter Shaun Kavanaugh was assigned its 1154484111 on 2006-12-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Peter Shaun Kavanaugh most recently updated or revised?
The details related to Peter Shaun Kavanaugh, including its address, specialty, and other relevant information, were last updated or revised on 2012-02-07.