Individual
DR. KENNETH MARC FOMBERSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E 77TH ST, LENOX HILL HOSPITAL, DEPARTMENT OF ANESTHESIOLOGY, NEW YORK, NY 10075
(212) 434-2878
Mailing address
100 E 77TH ST, LENOX HILL HOSPITAL, DEPARTMENT OF ANESTHESIOLOGY, NEW YORK, NY 10075-1850
(212) 434-2878
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
278926
NY
207L00000X
Anesthesiology Physician
52958
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P P01374947
RR MEDICARE
CT
05
—
P1114242435
—
CT
Enumeration date
03/30/2010
Last updated
04/30/2024
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