Kenneth E Wasserman, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD031626E Issued in PA

Practice address

1817 South Broad St
Philadelphia, PA 19148-2115

Phone

(215) 334-1300

Fax

(215) 334-0549

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenneth E Wasserman MD PC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1528080512
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346254703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 SOUTH BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482115",
            "telephone_number": "215-334-1300",
            "fax_number": "215-334-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 SOUTH BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482115",
            "telephone_number": "215-334-1300",
            "fax_number": "215-334-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD031626E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Wasserman, M.D.
• Ashley Wasserman, OTR/L
• Charles M. Wasserman, DO
• Deena Diamond Wasserman, M.D.
• Eleanor Wasserman, LSW
• Sara Dana Wasserman, M.D.
• Alan Wasserstein, MD
• Sophia Victoria Wasserwald, CRNP
• Emily Kathryn Wassmer, MD
• Jacqueline Wasynczuk, PHARMD

• Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.