Doctor Name: | DR. KENNETH WORTMAN |
NPI Number: | 1114900370 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 121285 |
Business Practice Address: | 440 Seaview Ave Staten Island, NY - 103053401 |
Business Phone Number: | 7182266550 |
Business Fax Number: | |
Mailing Address: | 1 Edgewater St, Suite 723 STATEN ISLAND |
State: | NY |
Postal Code: | 103054900 |
Phone Number: | 7182261008 |
Fax Number: | 7182261039 |
NPI Enumeration Date: | 11/22/2005 |
NPI Last Update Date: | 06/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 121285 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |