Fennoy, Ilene
Fennoy, Ilene is an individual health care provider with primary practice located at 3959 Broadway Chn 106, New York NY 10032. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Fennoy, Ilene can be contacted via phone (212) 305-6559.Contact Information
Primary practice address
3959 Broadway Chn 106
New York NY 10032
Phone: (212) 305-6559
Fax: (212) 305-4778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 122361 | New York |
| Allopathic & Osteopathic Physicians / Pediatric Endocrinology | 2080P0205X | 122361 | New York |
Profile Details
| NPI number | 1770575862 |
|---|---|
| LBN Legal business name | Fennoy, Ilene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Jul 8th, 2007 - 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 | 1770575862 | NPPES |
| New York | MEDICAID | 01126769 |
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