Individual
MS. KENISHA DANIA ATWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
496 COUNTY ROAD 111 BLDG D, MANORVILLE, NY 11949-3383
(631) 727-5065
Mailing address
496 COUNTY ROAD 111 BLDG D, MANORVILLE, NY 11949-3383
(631) 727-5065
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
325472
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2015
Last updated
09/01/2023
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