# GENNADIY KVETNY PHYSICIAN, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** none
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376747378
- **Authorized official:** DR. GENNADIY KVETNY MD (PHYSICIAN)
- **Authorized official phone:** (718) 894-4200

## Contact information

- **Practice address:** 7554 METROPOLITAN AVE, MIDDLE VILLAGE, NY 11379-2639
- **Practice address phone:** (718) 894-4200
- **Practice address fax:** (718) 894-3900
- **Mailing address:** 7554 METROPOLITAN AVE, MIDDLE VILLAGE, NY 11379-2639
- **Mailing address phone:** (718) 894-4200
- **Mailing address fax:** (718) 894-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 208977 | NY | Yes |

## Other

- **Enumeration date:** 06/13/2007
- **Last updated:** 04/06/2010