Kenneth E Wasserman MD PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD031626E Issued in PA

Legal business name

KENNETH E WASSERMAN MD PC

Practice address

1817 South Broad St
Philadelphia, PA 19148-2115

Phone

(215) 334-1300

Fax

(215) 334-0549

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth E Wasserman, MD

Title

President

Phone

(215) 334-1300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528080512",
    "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": {
        "organization_name": "KENNETH E WASSERMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-334-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD031626E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uchenna Katharina Kennedy, M.D.
• Regina Bridget Kennelly, MD
• Donna Marie Kenner- Whitaker, FNP
• Melisa Rosita Kenner, CRNP, PMHNP
• Paula Nadine Kenner, CERTIFIED HAIR LOSS
• Kenneth J Soapes, D.M.D & Associate
• Kenneth L. Kershbaum MD, Facc ,LLC
• Amy Raffety Kennett, RD
• Courtney Kenney, LCSW
• Gillian Kenney

• 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 Aug 22, 2020; 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.