Provider Demographics
NPI:1174565923
Name:EINHORN, KENNETH H (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:H
Last Name:EINHORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:994 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:SUITE 1017
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1802
Mailing Address - Country:US
Mailing Address - Phone:610-902-6092
Mailing Address - Fax:610-902-6081
Practice Address - Street 1:1245 HIGHLAND AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3714
Practice Address - Country:US
Practice Address - Phone:215-886-1482
Practice Address - Fax:215-886-1491
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043665E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011613740001Medicaid
PA183252Medicare ID - Type Unspecified
PA0011613740001Medicaid