Genesis Ketamine Centers

NPI #1730886888 in Bala Cynwyd, Pennsylvania

Provider Information

NPI Number: 1730886888
Entity Type: Organization
Organization Name: Genesis Ketamine Centers
Primary Specialty: Anesthesiology
Enumeration Date: Feb 9, 2023
Last Updated: Feb 9, 2023

Practice Location

Address: 1 BALA AVE STE 418
City: Bala Cynwyd
State: Pennsylvania
ZIP Code: 19004-3207
Phone: (267) 361-0315

Authorized Official

Name: MRS. KELLY SHAW
Title: PRACTICE MANAGER
Phone: (267) 361-0315

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Anesthesiology	207L00000X	Primary

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