Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Genesis Ketamine Centers

Organization Anesthesiology Physician · NPI 1730886888

Genesis Ketamine Centers is an Anesthesiology Physician in Bala Cynwyd, Pennsylvania. Works from 2 locations. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2

Practice location Address checks out

1 Bala Ave Ste 418
Bala Cynwyd, PA 19004-3207
Phone: (267) 361-0315
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2701 E Oakland Park Blvd Ste D, Fort Lauderdale, FL 33306-1655 — (754) 225-6412

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1730886888
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelly Shaw — Practice Manager · (267) 361-0315
NPI enumeratedFebruary 9, 2023
Last updated in NPPESFebruary 9, 2023
Certification dateFebruary 9, 2023
Mailing address1 Bala Ave Ste 418, Bala Cynwyd, PA 19004-3207

Other providers in Bala Cynwyd