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General NPI Number Information
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NPI Number | 1710854526
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Entity Type | Organization
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Legal Business Name | KEN HALL ENTERPRISES LLC
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 8080 TURIN RD
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City | ROME
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State | NY
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Zip | 13440-1910
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Country | US
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Telephone | 315-922-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 8080 TURIN RD
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City | ROME
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State | NY
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Zip | 13440-1910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY IRIZARRY
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Credential |
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Telephone | 315-525-0432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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