Pickover, Kenneth Howard
Pickover, Kenneth Howard is an individual health care provider with primary practice located at 59 Revere St Suite A, Staten Island NY 10301-3415. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Pickover, Kenneth Howard can be contacted via phone (718) 556-3900.Contact Information
Primary practice address
59 Revere St Suite A
Staten Island NY 10301-3415
Phone: (718) 556-3900
Fax: (718) 273-3592
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 164175 | New York |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 164175 | New York |
Profile Details
| NPI number | 1528055076 |
|---|---|
| LBN Legal business name | Pickover, Kenneth Howard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Feb 21st, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528055076 | NPPES |
| New York | MEDICAID | 01087645 |
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