MEDICARE: KENNETH DELA SENELORM PHARM.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	I053052	NY

General Provider Information

NPI Number	:	1619299427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH DELA SENELORM PHARM.D

Provider Business Mailing Address
First Line	:	18 METROPOLITAN OVAL APT 5D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-6791
Country	:	US
Telephone Number	:	718-239-5440
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 MAIN ST
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-2240
Country	:	US
Telephone Number	:	973-395-2713
Fax Number	:	973-395-2715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2010
Last Update Date	:	01/28/2026

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