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General NPI Number Information
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NPI Number | 1851370662
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Entity Type | Individual
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Provider Name | KEVIN PRITCHETT PA
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 308 E 175TH ST
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City | BRONX
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State | NY
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Zip | 10457-5804
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Country | US
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Telephone | 718-960-7618
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Fax | 718-901-1118
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Provider Business Mailing Address
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Address Line | 87 COSSIO DR
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City | NEWARK
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State | NJ
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Zip | 07103-3164
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001026
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License Number State | NY
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