Wortman, Kenneth
Wortman, Kenneth is an individual health care provider with primary practice located at 440 Seaview Ave , Staten Island NY 10305-3401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Wortman, Kenneth can be contacted via phone (718) 226-6550.Contact Information
Primary practice address
440 Seaview Ave
Staten Island NY 10305-3401
Phone: (718) 226-6550
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 121285 | New York |
Profile Details
| NPI number | 1114900370 |
|---|---|
| LBN Legal business name | Wortman, Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Jun 10th, 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 | 1114900370 | NPPES |
| New York | MEDICAID | 00995395 |
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