Pardo, Kenneth Mark

Pardo, Kenneth Mark is an sole proprietor health care provider with primary practice located at 22 Yale Ter , Blauvelt NY 10913-1421. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pardo, Kenneth Mark can be contacted via phone (845) 365-0449.

Contact Information

Primary practice address
22 Yale Ter Blauvelt NY 10913-1421
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 034602 New York

Profile Details

NPI number 1477685113
LBN Legal business name Pardo, Kenneth Mark
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Jul 8th, 2007 - about 19 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 1477685113 NPPES
New York MEDICAID 02701724

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