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

Last updated

Aug 22, 2020By the provider in NPPES

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, MDNPI 1346254703

Title

President

Phone

(215) 334-1300

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth E Wasserman, MD

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1346254703
  Authorized official Same address or phone

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.