| Genesis Ketamine Centers | |
|
1 Bala Ave Ste 418 Bala Cynwyd PA 19004-3207 | |
| (267) 361-0315 | |
| Not Available |
| Full Name | Genesis Ketamine Centers |
|---|---|
| Speciality | Anesthesiology |
| Location | 1 Bala Ave Ste 418, Bala Cynwyd, Pennsylvania |
| Authorized Official Name and Position | Kelly Shaw (PRACTICE MANAGER) |
| Authorized Official Contact | 2673610315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Ketamine Centers 1 Bala Ave Ste 418 Bala Cynwyd PA 19004-3207 Ph: (267) 361-0315 | Genesis Ketamine Centers 1 Bala Ave Ste 418 Bala Cynwyd PA 19004-3207 Ph: (267) 361-0315 |
| NPI Number | 1730886888 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 02/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730886888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 207L00000X | Anesthesiology | (* (Not Available)) | Primary |
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