Individual
KENNETH FRETWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8900 VAN WYCK EXPRESSWAY, SURGICAL SUITE 1ST FLOOR, JAMAICA, NY 11418
(718) 206-7110
(718) 206-7111
Mailing address
8906 135TH STREET, 7L, JAMAICA, NY 11418
(718) 206-7820
(718) 206-6786
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
190443
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01618666
—
NY
Enumeration date
03/28/2006
Last updated
03/28/2013
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