Berry, Kenneth M

Berry, Kenneth M is an individual health care provider with primary practice located at 9002 Queens Blvd , Elmhurst NY 11373-4941. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Berry, Kenneth M can be contacted via phone (718) 558-1000.

Contact Information

Primary practice address
9002 Queens Blvd Elmhurst NY 11373-4941
Phone: (718) 558-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 168383 New York
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 168383 New York
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD039776L Pennsylvania

Profile Details

NPI number 1316950942
LBN Legal business name Berry, Kenneth M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Nov 15th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316950942 NPPES
Pennsylvania Other 11890666 CAQH

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