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General NPI Number Information
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NPI Number | 1871891440
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Entity Type | Organization
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Legal Business Name | KENNETH TREADWELL JR. MD PC
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 1387 CLINTON AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111-1442
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Country | US
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Telephone | 973-372-1441
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Fax | 973-372-6019
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Provider Business Mailing Address
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Address Line | 1387 CLINTON AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111
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Country | US
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Telephone | 973-372-1441
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Fax | 973-372-6019
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH TREADWELL JR.
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Credential | MD
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Telephone | 973-372-1441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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