MEDICARE: SAMUEL DONKENG KENOU

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	251J00000X	Nursing Care Agency
2	163W00000X	Registered Nurse	N38468	NY

General Provider Information

NPI Number	:	1922935162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL DONKENG KENOU

Provider Business Mailing Address
First Line	:	2109 SEWARD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-1751
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2109 SEWARD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-1751
Country	:	US
Telephone Number	:	646-942-6513
Fax Number	:

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/08/2026

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