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NPI Code Detail

MEDICARE: PATRICIA H KENIS S.W.

MEDICARE: PATRICIA H KENIS S.W.
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
11041C0700XClinical Social WorkerR049413-1NY

General Provider Information

NPI Number : 1245475359
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA H KENIS S.W.
Provider Business Mailing Address
First Line : 118 PALMER PL
Second Line :
City : LEONIA
State : NJ
Zip : 07605-1317
Country : US
Telephone Number : 201-242-9525
Fax Number :
Provider Business Practice Location Address
First Line : 99 FORT WASHINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10032-4655
Country : US
Telephone Number : 212-342-2290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2008
Last Update Date : 12/04/2008

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