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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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 1114900370 NPPES
New York MEDICAID 00995395

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