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Individual

DR. BRIAN P MCKENNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3001 EXPRESSWAY DR N, SUITE 116, ISLANDIA, NY 11749-5301
(631) 292-6747
(631) 292-6767
Mailing address
3001 EXPRESSWAY DR N, SUITE 116, ISLANDIA, NY 11749-5301
(631) 292-6747
(631) 292-6767

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
181486
NY
207VG0400X
Gynecology Physician
181486
NY
207VX0000X
Obstetrics Physician
181486
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01344825
NY
01
0203186
GHI
NY
01
1226509
UNITED HEALTHCARE
NY
01
160054763
RAILROAD MEDICARE
NY
01
181486
HIP
NY
01
181486A28
HEALTHFIRST
NY
01
3C1748
HEALTHNET PHS
NY
01
4256082
AETNA
NY
01
466E91
BLUE CROSS BLUE SHIELD
NY
01
9605709002
CIGNA
NY
01
CP281
OXFORD
NY
01
P43029594
MULTIPLAN
NY
Enumeration date
02/17/2006
Last updated
12/06/2012
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