Individual
DR. KENNETH PAUL SUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16 BRENTWOOD DR, ITHACA, NY 14850
(607) 339-0680
(607) 319-5532
Mailing address
1301 TRUMANSBURG RD STE P, ITHACA, NY 14850-1397
(607) 277-2365
(607) 277-1415
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
244080
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03168114
—
NY
Enumeration date
08/16/2006
Last updated
08/14/2018
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