Individual
JOHN M MCKENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 BUSINESS PARK DR, UTICA, NY 13502-6399
(315) 792-4666
(315) 798-1893
Mailing address
1 OXFORD RD, NEW HARTFORD, NY 13413-2668
(315) 624-9081
(315) 734-9602
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1620083
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01647929
—
NY
Enumeration date
03/31/2006
Last updated
08/06/2020
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