Mcculloch, Kenneth

Mcculloch, Kenneth is an individual health care provider with primary practice located at 6336 99Th St , Rego Park NY 11374-1979. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Mcculloch, Kenneth can be contacted via phone (718) 275-1919.

Contact Information

Primary practice address
6336 99Th St Rego Park NY 11374-1979
Phone: (718) 275-1919
Fax: (718) 275-1955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 220173 New York

Profile Details

NPI number 1831199819
LBN Legal business name Mcculloch, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jan 15th, 2014 - about 11 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 1831199819 NPPES
New York MEDICAID 02880679

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