Individual
KENJI IKEMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 YORK AVE, NEW YORK, NY 10065-4805
(949) 370-3777
Mailing address
1300 YORK AVE, NEW YORK, NY 10065-4805
(949) 370-3777
Taxonomy
Speciality
Code
Description
License number
State
207ZC0008X
Clinical Informatics (Pathology) Physician
Primary
314673-01
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
314673-01
NY
Other
Enumeration date
04/04/2018
Last updated
08/19/2024
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