Mckennan, John M

Mckennan, John M is an individual health care provider with primary practice located at 107 Business Park Dr , Utica NY 13502-6399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mckennan, John M can be contacted via phone (315) 792-4666.

Contact Information

Primary practice address
107 Business Park Dr Utica NY 13502-6399
Fax: (315) 798-1893
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 1620083 New York

Profile Details

NPI number 1588625297
LBN Legal business name Mckennan, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Aug 6th, 2020 - about 4 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 1588625297 NPPES
New York MEDICAID 01647929

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