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Individual

DR. KENNETH PAUL WANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
27110 GRAND CENTRAL PKWY 6U, FLORAL PARK, NY 11005-1206
(718) 229-3326
Mailing address
27110 GRAND CENTRAL PKWY 6U, FLORAL PARK, NY 11005-1206

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X4192
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO-4192-3
WORKERS COMPENSATION NUMB
NY
Enumeration date
04/18/2007
Last updated
07/08/2007
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