Individual
DR. KENNETH PATRICK WENTHEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1701 SUNRISE HWY, UNIT FSU4, BAY SHORE, NY 11706-6091
(631) 665-6309
Mailing address
1701 SUNRISE HWY, UNIT FSU4, BAY SHORE, NY 11706-6091
(631) 665-6309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008325
NY
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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