MEDICARE: KENNETH STEVEN ROWIN M.D.

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
1	207RI0200X	Infectious Disease Physician	137171	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	277AV2	OTHER	NY	EMPIRE BC/BS

General Provider Information

NPI Number	:	1629077664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH STEVEN ROWIN M.D.

Provider Business Mailing Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 102
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2226
Country	:	US
Telephone Number	:	845-358-1344
Fax Number	:	845-358-8073

Provider Business Practice Location Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 102
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2226
Country	:	US
Telephone Number	:	845-358-1344
Fax Number	:	845-358-8073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/05/2008

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