Individual
DR. KENNETH WORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
440 SEAVIEW AVE, STATEN ISLAND, NY 10305-3401
(718) 226-6550
Mailing address
1 EDGEWATER ST, SUITE 723, STATEN ISLAND, NY 10305-4900
(718) 226-1008
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
121285
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00995395
—
NY
Enumeration date
11/22/2005
Last updated
06/10/2008
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