Individual
KENNETH EHRENSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2124 BARTOW AVE, BRONX, NY 10475-4615
(718) 379-2020
Mailing address
500 E 77TH ST, APT 1222, NEW YORK, NY 10162-0025
(917) 447-4558
(718) 320-7053
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
003974
NY
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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