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General NPI Number Information
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NPI Number | 1932191038
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Entity Type | Individual
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Provider Name | SAMUEL KENAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 317 E 34TH ST
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City | NYC
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State | NY
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Zip | 10016-4974
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Country | US
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Telephone | 212-684-5511
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Fax | 212-684-6611
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Provider Business Mailing Address
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Address Line | 16 OLD SEARINGTOWN RD
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City | ALBERTSON
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State | NY
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Zip | 11507-1532
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Country | US
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Telephone | 516-248-7756
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Fax | 212-684-6611
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 181971
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License Number State | NY
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