Charleston, Kimberly
Charleston, Kimberly is an sole proprietor health care provider with primary practice located at 7051 Passyunk Ave , Philadelphia PA 19142-1724. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Charleston, Kimberly can be contacted via phone (215) 492-1079.Contact Information
Primary practice address
7051 Passyunk Ave
Philadelphia PA 19142-1724
Phone: (215) 492-1079
Fax: (215) 492-1083
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | SL002343L | Pennsylvania |
Profile Details
| NPI number | 1174794754 |
|---|---|
| LBN Legal business name | Charleston, Kimberly |
| Credentials | MSCCCSLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 21st, 2008 |
| Last updated | Mar 21st, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174794754 | NPPES |
| Pennsylvania | MEDICAID | 0019719730003 |
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