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Individual

DR. GENNADIY KVETNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7554 METROPOLITAN AVE, MIDDLE VILLAGE, NY 11379-2639
(718) 894-4200
(718) 894-3900
Mailing address
7554 METROPOLITAN AVE, MIDDLE VILLAGE, NY 11379-2639
(718) 894-4200
(718) 894-3900

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208977
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01897043
NY
Enumeration date
03/27/2006
Last updated
08/23/2010
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