Provider Demographics
NPI:1871763565
Name:RECK, KENNETH J JR (PA)
Entity type:Individual
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First Name:KENNETH
Middle Name:J
Last Name:RECK
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:1300 PICCARD DRIVE
Mailing Address - Street 2:SUITE 202 EMERGENCY MEDICINE ASSOCIATES
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4303
Mailing Address - Country:US
Mailing Address - Phone:301-921-7900
Mailing Address - Fax:301-921-7915
Practice Address - Street 1:8700 SUDLEY ROAD
Practice Address - Street 2:PRINCE WILLIAM HOSPITAL
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-369-8337
Practice Address - Fax:703-369-8868
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2019-11-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant