Prushik, Kenneth H
Prushik, Kenneth H is an individual health care provider with primary practice located at 1994 Wellness Blvd Ste 110 , Monroe NC 28110-7768. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Prushik, Kenneth H can be contacted via phone (704) 384-8460.Contact Information
Primary practice address
1994 Wellness Blvd Ste 110
Monroe NC 28110-7768
Phone: (704) 384-8460
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2018-00935 | North Carolina |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 228253-1 | New York |
Profile Details
| NPI number | 1740290162 |
|---|---|
| LBN Legal business name | Prushik, Kenneth H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Aug 31st, 2023 - about 2 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 | 1740290162 | NPPES |
| New York | Other | 0600898 | GHI |
| New York | Other | 556Y51 | GHI |
| New York | MEDICAID | 02461633 | GHI |
| New York | Other | 3C3318 | GHI |
| New York | Other | P2939540 | GHI |
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