Individual
ETAOIN KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
622 W 168TH ST PH 16, NEW YORK, NY 10032-3720
(212) 305-4098
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-4098
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
273457
NY
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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