Kcomt, Juanita Regina

Kcomt, Juanita Regina is an individual health care provider with primary practice located at 735 Fitzwatertown Rd #1, Willow Grove PA 19090-1332. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Kcomt, Juanita Regina can be contacted via phone (215) 657-2012.

Contact Information

Primary practice address
735 Fitzwatertown Rd #1 Willow Grove PA 19090-1332
Fax: (215) 657-2018
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD432340 Pennsylvania

Profile Details

NPI number 1285744516
LBN Legal business name Kcomt, Juanita Regina
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated May 26th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285744516 NPPES
Pennsylvania MEDICAID 10963034002

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