Organization
GENNADIY KVETNY PHYSICIAN, PC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENNADIY KVETNY MD (PHYSICIAN)
(718) 894-4200
Entity
Organization
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
06/13/2007
Last updated
04/06/2010
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